Prognostic significance of reduced red blood cell deformability in severe falciparum malaria
Prognostic significance of reduced red blood cell deformability in severe falciparum malaria
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DOI：
10.4269/ajtmh.1997.57.507
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发表时间：
1997-11-01
影响因子：
3.3
通讯作者：
Vreeken, J
中科院分区：
文献类型：
--
作者：
Dondorp, AM;Angus, BJ;Vreeken, J
由于红细胞变形性降低(RBC-D)可导致微循环Dow受损，严重恶性疟疾与含有成熟期的红细胞隔离导致的微血管阻塞有关，因此对23例严重恶性疟疾患者(其中7人随后死亡)、30名无并发症疟疾患者和17名健康对照进行了RBC-D检测。红细胞计数法测得的RBC-D在严重疟疾患者中显著降低，在所有死亡病例中尤其低。在1.7Pascal(PA)的低切应力下，入院时红细胞伸长指数<0.21预测死亡结果的敏感性为100%(可信区间=59-100%)，特异性为88%(CI=61-98%)，RBC-D的降低似乎主要是由于未寄生性红细胞的变化。严重疟疾患者未寄生红细胞变形性降低可能是导致严重恶性疟疾患者微循环受损的原因之一。
Severe falciparum malaria is associated with microvascular obstruction resulting from sequestration of erythrocytes containing mature stages of the parasite, Since reduced red blood cell deformability (RBC-D) can contribute to impaired microcirculatory dow, RBC-D was measured in 23 patients with severe falciparum malaria (seven of whom subsequently died), 30 patients with uncomplicated malaria, and 17 healthy controls. The RBC-D, measured by ektacytometry, was significantly reduced in severe malaria and was particularly low in all fatal cases. At a low shear stress of 1.7 Pascal (Pa), a red blood cell elongation index less than 0.21 on admission to the hospital predicted fatal outcome with a sensitivity of 100% (confidence interval [CI] = 59-100%) and a specificity of 88% (CI = 61-98%), The reduction in the RBC-D appeared to result mainly from changes in unparasitized erythrocytes. Reduced deformability of unparasitized red blood cells in severe malaria may contribute to impaired microcirculatory how and a fatal outcome in severe falciparum malaria.