输入性恶性疟疾重症相关危险因素logistic回归分析  

Logistic regression analysis of risk factors related to severe imported falciparum malaria

作　　者：吴霜 文丹宁 余树坤 潘姝 谢丹 龙克娇 傅翀 郑汉丹 罗丹 李华东 WU Shuang;WEN Dan-ning;YU Shu-kun;PAN Shu;XIE Dan;LONG Ke-jiao;FU Chong;ZHENG Han-dan;LUO Dan;LI Hua-dong(Wuhan Jinyintan Hospital,Wuhan,Hubei 430023,China;Dongxihu District Center for Disease Control and Prevention,Wuhan,Hubei 430040,China)

机构地区：[1]武汉市金银潭医院,湖北武汉430023 [2]武汉市东西湖区疾病预防控制中心,湖北武汉430040

出　　处：《公共卫生与预防医学》2022年第6期72-75,共4页Journal of Public Health and Preventive Medicine

基　　金：武汉市医学科研项目(WG19Q09);湖北省卫生健康委员会联合基金项目(WJ2019H406)。

摘　　要：目的探讨分析重症恶性疟病例的危险因素,为临床早期预防及干预措施提供依据。方法选择2012年3月至2019年11月武汉市输入性恶性疟114例,分为轻症组(n=87)和重症组(n=27),对重症相关危险因素进行logistic回归分析。结果轻症组和重症组住院时间、红细胞、血红蛋白、血小板、尿素氮、肌酐、谷丙转氨酶、谷草转氨酶、白蛋白、肌酸激酶同工酶、乳酸脱氢酶、小便隐血及小便蛋白质差异有统计学意义(P<0.05)。多因素logistic回归分析提示谷丙转氨酶(OR=0.167,95%CI:0.042~0.668)、白蛋白(OR=24.843,95%CI:5.170~119.383)、尿素氮(OR=0.240,95%CI:0.074~0.779)、小便隐血(OR=0.204,95%CI:0.062~0.672)是恶性疟发生重症的独立影响因素。结论患者肝功能损害且谷丙转氨酶升高2倍以上(≥80U/L),白蛋白降低(<30g/L),肾功能损害尿素氮升高、出现血尿等异常结果时,应高度考虑恶性疟患者将进展为重症的可能。Objective To explore and analyze the risk factors of severe falciparum malaria cases,and to provide evidence for early clinical prevention and intervention measures.Methods A total of 114 imported cases of falciparum malaria in Wuhan from March 2012 to November 2019 were selected,divided into mild group(n=87)and severe group(n=27),and logistic regression analysis was performed on the risk factors of severe disease.Results There were significant differences in length of stay,erythrocyte,hemoglobin,platelet,urea,creatinine,albumin,creatine kinase isoenzyme,lactate dehydrogenase,urine occulting blood and urine protein between mild group and severe group(P<0.05).Multivariate Logistic regression analysis showed that alanine aminotransferase(OR=0.167,95%CI:0.042-0.668),albumin(OR=24.843,95%CI:5.170-119.383),urea(OR=0.240,95%CI:0.074-0.779)and occulted blood in urine(OR=0.204,95%CI:0.062-0.672)were independent influencing factors for the occurrence of severe falciparum malaria.Conclusion Patients with liver function damage and alanine aminotransferase increased by more than 2 times(≥80U/L),albumin decreased(<30g/L),renal function damage,increased urea nitrogen,hematuria and other abnormal results,the possibility of severe falsiparum malaria development should be highly suspected.

关 键 词：恶性疟 重症 危险因素 LOGISTIC回归分析 

分 类 号：R181[医药卫生—流行病学]