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目的探讨输入性恶性脑型疟疾患者在发病期间,D-二聚体等实验室指标的异常变化,为防治工作提供参考。方法选取2013年在院确诊、住院治疗、治愈出院后的典型脑型疟疾病历资料一例,进行实验室数据分析,重点对血常规及D-二聚体、肝功能参数、尿常规及C反应蛋白分析。结果患者在急性发作期白细胞正常或偏低(2.8~4.2);血小板减少并呈现明显进行性下降(96,67,58,47,22);D-二聚体异常升高(14.4,12.8,12.7);肝功能显示转氨酶和胆红素均升高;尿蛋白、尿胆原呈现阳性,C反应蛋白升高。结论恶性脑型疟疾发病迅猛,临床表现复杂,易误诊,可能导致肾功衰竭等危象。了解恶性脑型疟疾患者在发病时实验室相关指标变化,给临床早期准确诊断提供参考。
Objective To investigate the abnormal changes of laboratory indexes such as D-dimer in patients with imported malignant cerebral malaria during the pathogenesis and provide a reference for prevention and treatment. Methods A case of typical cerebral malaria records confirmed during hospitalization, hospitalization and hospital discharge in 2013 was analyzed. Laboratory data were analyzed and the correlations of blood routine and D-dimer, liver function parameters, urine routine and C-reactive protein analysis. Results In patients with acute exacerbation of leukocytes normal or low (2.8 ~ 4.2); thrombocytopenia and showed a significant progressive decline (96,67,58,47,22); D-dimer abnormalities (14.4,12.8, 12.7); liver function showed elevated aminotransferase and bilirubin; urinary protein, urobilinogen positive, C-reactive protein increased. Conclusions The incidence of malignant cerebral malaria is very rapid, the clinical manifestations are complicated and easily misdiagnosed, which may lead to the crisis such as renal failure. To understand the laboratory-related changes of malignant cerebral malaria patients in the pathogenesis, to provide an accurate reference for early clinical diagnosis.