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目的探讨疟疾患者发作期和治疗期间外周血常规指标的变化。方法分析恶性疟患者与间日疟患者疟疾发作初期外周血细胞计数的改变情况,进一步探讨患者服用蒿甲醚一个疗程巩固治疗中其血常规指标的变化情况。结果恶性疟组和间日疟组血常规各参数比较差异均无统计学意义(P>0.05)。与健康对照组相比,恶性疟、间日疟患者在发作期治疗前外周血常规中淋巴细胞计数(LYMPH)和嗜酸性粒细胞计数(EO)降低(P<0.05);恶性疟组红细胞(RBC)、血红蛋白(Hb)、平均红细胞体积(MCV)、血小板(PLT)、血小板分布宽度(PDW)及平均血小板体积(MPV)与健康对照组比较,差异均有统计学意义(P<0.05);间日疟组Hb、MCV、PLT、MPV及血小板压积(PCT)与健康对照组比较,差异均有统计学意义(P<0.05)。恶性疟与间日疟患者服用蒿甲醚一个疗程期间外周血常规的中性粒细胞(NEUT)、单核细胞(MONO)、嗜碱性粒细胞(BASO)计数无明显变化(P>0.05),WBC总数、LYMPH、EO和PLT计数均有升高趋势,而RBC、Hb计数有下降趋势,观察到血常规散点图也有相应的改变。结论疟疾发作初期观察血常规指标和散点图的变化可辅助诊断疟疾感染,在治疗过程中,应密切关注RBC、Hb计数降低程度。
Objective To investigate the change of routine indexes of peripheral blood during the onset and treatment of malaria patients. Methods The changes of peripheral blood cell counts in the early stage of malaria episodes in patients with falciparum malaria and vivax malaria were analyzed, and the changes of blood routine indexes in patients undergoing maintenance therapy with artemether were further investigated. Results There was no significant difference in the blood parameters between P. falciparum and P. vivax (P> 0.05). Compared with the healthy control group, the levels of LYMPH and Eosin in peripheral blood were decreased before and after the onset of attack (P <0.05) in patients with P. falciparum and P. vivax. Erythrocytes RBC, Hb, MCV, PLT, PDW and MPV were significantly higher than those in healthy controls (P <0.05) (P <0.05). The differences of Hb, MCV, PLT, MPV and PCT between the control group and the healthy control group were statistically significant (P <0.05). There were no significant changes in routine neutrophil (NEUT), monocyte (MONO) and basophil (BASO) counts in patients with falciparum and vivax after taking artemether during one course of treatment (P> 0.05) , The total number of WBC, LYMPH, EO and PLT count increased, while the RBC and Hb count showed a downward trend, and the blood scatter plot was also observed. Conclusion In the early stage of malaria, the change of blood routine and scatter chart can be used to diagnose malaria infection. During the course of treatment, the reduction of RBC and Hb counts should be paid close attention to.