重症疟疾患儿视网膜病变的病程及其与疾病预后关系的研究

作     者：汪玲 Beare N.A Southern C Chalira C 

作者机构：St.Paul ’s Eye UnitRoyal Liver-pool University HospitalPrescot S treetLiverpool L78XPUnited King dom.Dr 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第1期

页      面：29-30页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：视网膜病变 疾病预后 检眼镜检查 眼底情况 眼底病变 疾病转归 研究计划 意识恢复时间 病理生理 存活者 

摘      要：Objectives:To relate retinal findi ngs in children treated for severe malaria to disease outcom e and to determine the course of changes in the *** ods:A prospective study of children with cerebral mala ria(CM)and severe malarial anemia admitted to the Mala ria Research Project,Blantyre,Malawi,during 2malaria s *** and direct ophthalmoscopy were perform ed on admission and daily,subject to the patients coop ***:Three hundred twenty six patients(91%)with complicated malaria were *** hundred seventy-eight pa-tients had CM and of these 170(61%)had some degree of retinopathy;25(53%)of 47with severe malarial anemia had *** CM,retin opathy was associ-ated with subsequent death(relative risk,3.7;95%confidence interval,1.6-8.5)and papilledema con-ferred the highest risk(relative risk,4.5;95%confi-dence interval,2.7-7.6).Increasing severity of retinal signs was related to increasing risk of a fatal outcome (P.05),independent of *** sur vivors,retinal signs were associated with p rolonged time to recover consciousness(P.001).Patients with severe malarial anemia had better outcomes and less s evere retinopathy than those with *** 116patients wi th CM,fundi were followed up longitudinally during a dmission and in 27pa-tients after hospital discharge.A l arge increase in retinal hemorrhages was associated with dea th(P=.02).Reti-nal signs resolved over 1to 4weeks wi thout retinal ***:In childhood C M,severity of retinopathy is related to prolonged coma and *** results support the hypothesis that retinal signs in CM are related to cerebral pathophysiolog y.