疟疾与其他疾病发热患者实验室指标回顾性分析

Retrospective analysis of laboratory indexes of febrile patients with malaria and other diseases

目的研究疟疾患者实验室指标情况,了解其实验室指标变化,为临床诊断及治疗疟疾提供一定指导。方法选取2021年12月—2022年5月就诊于加蓬共和国弗朗斯维尔市中加友谊医院的120例发热患者作为研究对象,根据不同病因分为疟疾组和非疟疾组,每组各60例。回顾性分析疟疾组患者的临床资料,了解患者的流行病学资料,实验室血常规、C反应蛋白(CRP)检测指标结果,并与非疟疾组实验室指标进行对比。比较疟疾组患者治疗前后的实验室指标变化,应用多因素二元Logistic,分析疟疾患者的实验室指标。结果治疗前,疟疾组WBC、PLT明显低于非疟疾组,差异均有统计学意义(P<0.05)。两组患者CRP水平均高于正常值,疟疾组患者低于非疟疾组,差异有统计学意义(P<0.05)。与治疗前比较,疟疾组经过抗疟原虫、对症及支持治疗后的HGB以及PLT水平明显上升,而CRP水平明显降低,差异均有统计学意义(P<0.05)。Logistic逐步回归分析疟疾的影响因素发现WBC和PLT与疟疾感染密切相关,均为保护性因素。患者疑似疟原虫感染时,CRP水平升高、WBC及HGB、PLT水平降低,与符合诊断呈正相关。结论检查患者的血常规以及CRP水平,有助于为临床早期诊断疟疾及治疗提供可靠的客观依据。

Objective To study the laboratory indexes of malaria patients,understand the changes of laboratory indexes,and provide some guidance for clinical diagnosis and treatment of malaria.Methods A total of 120 febrile patients treated in China Canada Friendship Hospital in Fransville,Gabon from December 2021 to May 2022 were selected as the research subjects and divided into malaria group and nonmalaria group according to different causes of disease,with 60 cases in each group.The clinical data of malaria group were retrospectively analyzed to understand the epidemiological data of patients,the test results of laboratory blood routine and C-reactive protein(CRP)test indicators,and compared with the laboratory indicators of non-malaria group.The changes of laboratory indexes of patients in malaria group before and after treatment were compared,and the laboratory indexes of malaria patients were analyzed by multivariate binary Logistic.Results Before treatment,WBC and PLT in malaria group were lower than those in non-malaria group,and the differences were statistically significant(P<0.05).The CPR level of the two groups was higher than the normal value,and that of the malaria group was lower than that of the nonmalaria group,and the difference was statistically significant(P<0.05).Compared with that before treatment,the levels of HGB and PLT in malaria group increased after anti malaria,symptomatic and supportive treatment,while the levels of CRP decreased,and the differences were statistically significant(P<0.05).Logistic stepwise regression analysis showed that WBC and PLT were closely related to malaria infection and were protective factors.When the patient was suspected of plasmodium infection,the levels of CRP increase,WBC,HGB and PLT decrease,which were positively correlated with the diagnosis.Conclusion Checking the blood routine and CRP level of patients was helpful to provide a reliable objective basis for early clinical diagnosis and treatment of malaria.