Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever
Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever
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DOI：
10.1086/318453
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发表时间：
2001-01-15
影响因子：
11.8
通讯作者：
Day, NPJ
中科院分区：
文献类型：
--
作者：
Bethell, DB;Gamble, J;Day, NPJ
登革休克综合征（DSS）是登革病毒感染的一种潜在致命的并发症，与低血压和血浆水渗漏到血管外空间有关。为了确定DSS的潜在病理生理学是否与较轻形式的疾病不同，我们通过使用应变计体积描记法评估了越南DSS儿童（n = 19）或无休克的登革出血热（DHF）儿童（n = 16）和健康对照儿童（n = 15）的微血管通透性。入院时和液体复苏后，登革热患者的平均微血管通透性系数（K-f）比对照组高出50%（P = 0.2）。两组登革热患者的K-f无显著差异;这表明相同的潜在病理生理学。我们假设在DSS患者中，K-f的波动大于DHF患者，这导致微血管通透性显著增加的短暂峰值和随后的血流动力学休克。
Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n = 19), or dengue hemorrhagic fever (DHF) without shock (n = 16), and in healthy control children (n = 15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K-f) for the patients with dengue was similar to 50% higher than that for the control patients (P = 0.2). There was no significant difference in K-f between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K-f are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.