静脉血压的姿势下降是登革热发烧中有用的警告信号
Chakrapani Mahabala1, Archith Boloor1, Sushmita Upadhya1
1Medicine, Kasturba Medical College , Mangalore , Manipal Academy Of Higher Education, Manipal, Karnataka, 575001, India.
F1000Research
|January 5, 2024
概括
姿势低血压是严重登革热的可靠早期预警信号,显示出高灵敏度和特异性. 这一发现支持将其纳入登革热管理指南,特别是在资源有限的地区.
科学领域:
- 传染性疾病 传染性疾病
- 热带医学 热带医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 毛细血管泄漏综合征是严重登革热发展的关键指标.
- 目前世卫组织,疾病预防控制中心和泛美卫生组织的指导方针认识到各种警告信号,包括血红素和体位低血压的上升,以预测严重的登革热.
- 作为严重登革热的标志物,姿势低血压的诊断准确性需要进一步评估.
研究的目的:
- 为了评估姿势低血压的诊断准确性,作为严重登革热发展的标志物.
- 为了比较姿势低血压与严重登革热检测常规预警信号的有效性.
主要方法:
- 一项前性观察性研究,涉及150名登革热患者.
- 评估了常规警告标志的诊断准确性 (例如,腹部疼痛,持续吐,液体积累,粘膜出血,昏迷,肝脏膨胀,随着血小板数量的减少而增加血红素) 和姿势低血压.
- 利用多重物流回归分析来确定不同符号的预测值.
主要成果:
- 23名 (15.3%) 患者发展为严重的登革热.
- 静止性血压下降>10.33%显示严重登革热的高诊断准确度 (灵敏度87%,特异性82.7%).
- 炎/多发性溢出也显示出显著的预测值 (灵敏度为82.6%,特异性为88.2%),与炎/多发性溢出 (5.024) 相比,姿势低血压的几率比率更高 (11.369).
结论:
- 姿势低血压是预测严重登革热的统计学上显著和准确的警告信号.
- 研究结果强烈支持将体位低血压纳入登革热的临床管理,特别是在资源有限的环境中.
- 这种标志物可以帮助早期识别和及时干预患有严重登革热风险的患者.
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