背景:据报道,登革热感染的严重程度与患者的过敏反应有关。为了进一步阐明过敏在登革热严重程度中的作用,我们进行了一项配对病例对照研究,以评估过敏背景与登革热休克综合征之间的关联.
方法:这是一项在热带病医院进行的配对病例对照研究,胡志明市,2017年1月至12月越南。通过非结构蛋白1(NS1)诊断快速测试或抗登革热抗体(IgM)确定登革热感染。使用ELISA测量总的和登革热特异性IgE水平。患者人口统计学,临床,使用结构化问卷收集过敏资料.
结果:本研究共纳入572例NS1阳性(92.7%)或IgM抗体阳性(7.3%)的登革热患者。在这些病人中,143例患者发展为登革热休克综合征(病例组),而其他429例未发展为登革热休克综合征(对照组)。没有基线特征,包括年龄,性别,两组之间存在显著差异(p>0.05)。在多变量分析中,有登革热感染史(OR=3.35,95%CI:1.8-6.17,p<0.001)和过敏性鼻炎(OR=1.95,95%CI:1.11-3.4,p=0.019)与登革热休克综合征相关.较高的登革热特异性IgE水平与过敏患者(p=0.204)或过敏性鼻炎患者(p=0.284)的不良预后无关。
结论:有登革热感染或过敏性鼻炎病史的登革热患者应被视为发展为登革热休克综合征的高危患者。
BACKGROUND: The severity of dengue infection has been reportedly associated with patients\' allergic reactions. To further elucidate the role of allergy in dengue severity, we conducted a matched
case-control study to assess the association between allergic background and dengue shock syndrome.
METHODS: This is a matched
case-control study that was carried out in the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from January to December 2017. Dengue infection was determined by non-structure protein 1 (NS1) diagnostic quick test or anti-dengue antibodies (IgM). The total and dengue-specific IgE levels were measured using ELISA. Patients\' demographics, clinical, and allergic profiles were collected using a structured questionnaire.
RESULTS: A total of 572 dengue patients with positive NS1 (92.7%) or IgM antibodies (7.3%) results were included in this study. Of these patients, 143 patients developed dengue shock syndrome (
case group) while the other 429 patients did not (control group). None of the baseline characteristics including age, sex, or being overweight was significantly different between the two groups (p>0.05). In multivariable analysis, having a history of dengue infection (OR=3.35, 95% CI: 1.8-6.17, p<0.001) and allergic rhinitis (OR=1.95, 95% CI: 1.11-3.4, p = 0.019) were found to be associated with dengue shock syndrome. Higher levels of dengue-specific IgE were not associated with worse outcomes in patients with allergies (p = 0.204) or allergic rhinitis (p = 0.284).
CONCLUSIONS: Dengue patients presenting with a history of a previous dengue infection or allergic rhinitis should be considered high-risk patients for the development of dengue shock syndrome.