Dengue: an evaluation of dengue severity in French Polynesia based on an analysis of 403 laboratory-confirmed cases
Dengue: an evaluation of dengue severity in French Polynesia based on an analysis of 403 laboratory-confirmed cases
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DOI：
10.1046/j.1365-3156.1999.00478.x
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发表时间：
1999-11-01
影响因子：
3.3
通讯作者：
Roche, C
中科院分区：
文献类型：
--
作者：
Murgue, B;Deparis, X;Roche, C
我们对1989年8月至1997年3月期间在塔希提岛住院的403例经实验室确认的登革热病例进行了回顾性研究。根据世界卫生组织标准，其中337例为登革热，为登革出血热。在10例死亡病例中，6例为DF，4例为DHF。作为另一种选择，我们使用对应分析程序来定义基于基本临床和生物学标准的登革热严重程度，并为其指定严重程度评分，然后从该分析中选择50个最严重的病例。在后者中，17例患者被世界卫生组织标准归类为DF，33例患者被归类为DHF。根据这项分析，与肝脏疾病相关的出血和血小板计数下降是与严重登革热病例相关的主要标准。因此，在我们的研究人群中，WHO的分类没有考虑到登革热的总体严重程度；肝功能衰竭应该被视为一种特定的严重形式的登革热，因为血浆泄漏是DHF的病理生理标志，只是导致严重程度的致病机制之一。
We conducted a retrospective study of 403 laboratory-confirmed dengue cases hospitalized in Tahiti between August 1989 and March 1997. According to standard WHO criteria, 337 of these cases were dengue fever (DF) and 64 were dengue haemorrhagic fever (DHF). Of the 10 fatal cases, 6 were DF and 4 were DHF. As an alternative, we used a correspondence analysis procedure to define dengue severity based on basic clinical and biological criteria for which we assigned a severity score, and then selected the 50 most severe cases from this analysis. Of the latter, 17 patients had been classified as DF and 33 as DHF by the WHO criteria. From this analysis, haemorrhages and decreased platelets counts associated with hepatic disorders are the main criteria associated with the severe dengue cases. Thus in our study population, the WHO classification does not account for the overall severity of dengue; hepatic failure should be considered as a specific severe form of dengue since plasma leakage, which is the pathophysiological hallmark of DHF, is only one of the pathogenic mechanisms leading to severity.