【摘要】 目的分析葡萄糖-6-磷酸脱氢酶(G6PD)活性对登革热患者疾病的影响。方法回顾性分析2013-2014年广州市第八人民医院同时进行登革病毒(DENV)基因分型和G6PD活性检测的327例登革热住院病人的临床资料,了解G6PD活性对登革热病情的影响,并进行单因素和多因素Logistic回归分析。结果纳入实验对象的327例登革热住院病人中,43例为G6PD缺乏症患者。登革热患者入院后最低血红蛋白(HGB)与G6PD活性成正相关(P<0.000 1,r=0.471 7);G6PD缺乏症患者入院时HGB较正常组明显下降(127 g/L vs. 139 g/L,P=0.005 8),住院期间最低HGB浓度较正常组明显下降(116 g/L vs. 129 g/L, P<0.000 1),且下降幅度高于正常组(9 g/L vs. 7 g/L,P=0.032 4),G6PD缺乏症组较正常组有更多的重型病人[7(16.28%)vs. 18(6.33%),P=0.022 2];单因素分析发现:性别、年龄、是否有G6PD缺乏症、最低HGB浓度、最低血小板(PLT)及最高红细胞压积(HCT)为重型登革热的重要影响因素。Logistic回归分析发现最低HGB浓度、最低PLT及是否G6PD缺乏为最重要影响预测因素,纳入3个因素构建函数,ROC曲线分析具有较好的灵敏度及特异性(曲线下面积为0.772,P<0.001)。结论 G6PD缺乏症可导致登革热患者HGB浓度明显下降,且与重型登革热的发生相关。更多还原

【Abstract】 Objective Analyzed glucose-6-phosphate dehydrogenase(G6PD)enzyme activity and the main influencing factors of dengue disease by a retrospective study. Methods By retrospectively analyzed the clinical data of 327 cases of dengue fever who underwent both dengue virus(DENV)genotyping and G6PD enzyme activity test at the Eighth People′s Hospital of Guangzhou from 2013 to 2014 were analyzed retrospectively to reveal the influence of G6PD enzyme activity to dengue fever,through single factor and logistic regression multiple factors analysis of the influence factors of severe dengue fever. Results A total of 327 inpatients were included in the study,including 43 patients with G6PD deficiency. This study found that the lowest hemoglobin concentration(HGB)was positively correlated with the activity of G6PD enzyme in patients with dengue fever(P<0.000 1,r=0.471 7). G6PD deficiency patients with HGB declined obviously than the normal group(127 g/L vs. 139 g/L,P= 0.005 8);HGB lowest concentration significantly lower than the normal group(116 g/L vs.129 g/L,P<0.000 1),and the decline of HGB was higher than the normal group(9 g/L vs. 7 g/L,P=0.032 4),and G6PD deficiency group patients have more severe patients than the normal group[7(16.28%)vs. 18(6.33%),P=0.022 2].Single factor analysis found that gender,age,G6PD deficiency,the lowest concentration of HGB,the lowest platelet(PLT) and the hematocrit(HCT) were the important influence factors of severe dengue fever,but logistic regression analysis found that only the lowest concentration of HGB,the lowest PLT and G6PD deficiency were the most important factors of severe dengue fever;using the three factors building the function,ROC curve analysis had good sensitivity and specificity(area under curve of 0.772,P<0.001). Conclusion G6PD deficiency could lead to dengue patients HGB significantly decreased,and associated with the occurrence of severe dengue fever.更多还原