5例登革热患者口服钙加维生素D的临床反应分析。

Emilio Sánchez-Valdéz, Melissa Delgado-Aradillas, José Angel Torres-Martínez, José Martín Torres-Benítez
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引用次数: 0

摘要

登革热流行是世界热带和亚热带地区最重要的公共卫生问题之一。2005年,墨西哥东海岸塔毛利帕斯州报告了7062例登革热病例,其中1832例(26%)被列为登革出血热。登革热的特征是发热、剧烈头痛、肌痛、关节痛、皮疹、恶心和呕吐。一部分感染者可能发展DHF,其特征是与血小板减少症相关的突出出血表现。由于血小板破坏增加导致的血小板减少的免疫机制似乎在DHF患者中起作用。毛细血管通透性过度可导致登革休克综合征(DSS)。伴有持续发热(> 5天)的DHF/DSS患者存在并发菌血症的高风险。标准治疗仅限于电解溶液、休息、测量体温、血压、血细胞比容、血小板计数,并在发烧过高时使用退烧药,如扑热息痛。细胞外钙在感染登革病毒(DV)的人的血小板聚集和免疫反应调节中起关键作用,最近发现二羟基维生素D可以改变IL-12表达和树突状细胞成熟。我们报告了5例接受口服碳酸钙加维生素D3的患者,他们改善了总体临床状况,缩短了DF症状和体征的持续时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical response in patients with dengue fever to oral calcium plus vitamin D administration: study of 5 cases.

A dengue epidemic is one of the most important public health problems in the tropical and subtropical areas of the World. In 2005, 7,062 dengue cases were reported in Tamaulipas on Mexico's eastern coast, including 1,832 (26%) cases classified as Dengue Hemorrhagic Fever (DHF). Dengue fever (DF) is characterized by fever, intense headache, myalgias, arthralgias, rash, nausea and vomiting. A proportion of infected persons may develop DHF characterized by prominent hemorrhagic manifestations associated with thrombocytopenia. An immune mechanism of thrombocytopenia due to increased platelet destruction appears to be operative in patients with DHF. Excessive capillary permeability may lead to Dengue Shock Syndrome (DSS). Patients with DHF/DSS who also have prolonged fever (> 5 days) are at high risk for concurrent bacteremia. Standard treatment is limited to electrolytic solutions, rest, measurements of body temperature, blood pressure, hematocrit, platelet count, and administration of antipyretics like paracetamol when fever is too high. Extracellular calcium plays a key role in platelet aggregation and for the regulation of the immune response in personsinfected with Dengue Virus (DV), and dihydroxy-vitamin D has recently been found to alter IL-12 expression anddendritic cell maturation. We report the cases of five patients who received oral calcium carbonate plus Vitamin D3, who improved overall clinical condition and reduced the duration of signs and symptoms of DF.

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