脳のマラリアにおける脳脊髄液の乳酸の病理生理学的および予後的重要性
Lancet (London, England)
|April 6, 1985
まとめ
脳脊髄液 (CSF) の乳酸濃度の上昇は,脳マラリア患者における予後が悪いことを示している. 高濃度のCSF乳酸は,低酸素がこの重症疾患に寄与することを示唆し,回復後にレベルが正常化する.
科学分野:
- 神経学 神経学とは
- 感染症 感染症は感染症です.
- バイオケミストリー バイオケミストリー
背景:
- 脳マラリアは,Plasmodium falciparum感染症の重篤な合併症である.
- 脳のマラリアの病原性における代謝障害,特に乳酸の役割は完全に理解されていません.
研究 の 目的:
- 脳脊髄液 (CSF) の乳酸濃度と脳マラリアの患者のアウトカムとの相関を調査する.
- CSFの乳酸塩濃度が予後指標として役立つかどうかを判断する.
主な方法:
- 脳のマラリアを患った45人の患者で,CSFの乳酸塩濃度の測定.
- 生き残った人と生き残らなかった人の間でのCSF乳酸濃度の比較.
- CSFの乳酸とCSFのグルコース濃度の相関分析.
- 回復後の患者のサブセットにおけるCSF乳酸濃度のモニタリング.
主要な成果:
- CSF乳酸は,45人の患者のうち44人に上昇しました.
- CSFの乳酸塩濃度が大幅に上昇したのは,生存者 (3.4 +/- 1.1 mmol/l) と比較して,生存者でない人 (9.0 +/- 5.3 mmol/l) であった.
- CSFの乳酸とCSFのグルコースの間には負の相関が認められた.
- CSF乳酸6mmol/l以上の患者全員が死亡しました.
- CSF乳酸は,回復後の患者で正常化しました.
結論:
- CSF乳酸は,脳マラリアの有意な予後マーカーです.
- CSF乳酸の上昇は,脳マラリアの病理生理学における低酸素の役割を示唆しています.
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