CÁC YẾU TỐ TIÊN LƯỢNG BỆNH SỐT XUẤT HUYẾT DENGUE DỰA VÀO CÁC BIOMARKERS

Abstract

Purpose: To study the predictive markers of Dengue hemorrhagic fever progressing.

Methods: A multicenter cross - sectional study, consisting of 200 DHF patients ≥ 18 years of age and during the epidemic in 2017. Hematological, biochemical, coagulation and interlekin.

Results: Univariate analysis showed that the prognostic parameters in the first 3 days of fever included hematocrit > 40%, platelets < 100,000/mm3, APTT > 40s and APTTr > 1,2. From days 4 to 6 of the fever were hematocrit > 40%, platelets ≤ 50,000/mm3, PTs and APTT (s) rose above the threshold, albumin < 35g/L; AST/ALT > 400U/L, total bilirubin > 17µmol/L; creatinine > 120µmol/L. The multivariate analysis results showed that the markers had prognostic value for severe dengue disease, in the first 3 days were platelets <100 x 103/mm3 (OR = 4.69; 95% CI 1.93 - 11.39), APTT > 40s (OR = 11.39; 95% CI 5.14 - 25.22), APTTr > 1.2s (OR = 4.1; 95% CI 1.35 - 12.45). From 4 - 6 days, albumin < 35 g/l (OR = 27.4; 95% CI 8.3 - 89.8), total bilirubin > 17µmol/L (OR = 36.04; 95% CI 2, 7 - 480,9). The indicators of interleukin (IL6, IL10, TFNa) have no predictive and prognostic values in clinical practice. Conclusions: In managing dengue patients, in addition to classifying DHF in three clinical forms, need to be used biomarkers to predict the risk of developing severe dengue disease.