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2016, vol. 35, br. 4, str. 451-457
Značaj hematoloških i biohemijskih nalaza kod bolesnika sa neuroinvazivnim oblikom groznice Zapadnog Nila
aUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za infektivne i tropske bolesti, Beograd
bUniverzitet u Beogradu, Medicinski fakultet
cKlinički centar Srbije, Beograd
dKlinički centar Srbije, Klinika za infektivne i tropske bolesti, Beograd

e-adresagoran.drste@gmail.com
Ključne reči: CST; encefalitis; leukociti; meningitis; Zapadni Nil
Sažetak
Uvod: Do neuroinvazivnog oblika groznice Zapadnog Nila (WNND) dolazi kod manje od 1% zaraženih osoba. Kod bolesnika sa WNND se mogu registrovati leukocitoza sa limfocitopenijom, laka anemija, trombocitopenija, povišene vrednosti enzima jetre i mišića i hiponatrijemija. Nalaz u cerebrospinalnoj tečnosti (CST) sličan je kao kod drugih virusnih neuroinfekcija. Cilj rada je prikaz laboratorijskih parametara kod naših bolesnika sa WNND i određivanje njihove korelacije sa smrtnim ishodom. Metode: U studiju je uključen 161 bolesnik sa WNND. Uzorci njihove krvi i CST su citobiohemijski analizirani i potom je testiran prediktivni značaj dobijenih varijabli na ishod bolesti ili značajnost razlike u zavisnosti od kliničkog sindroma (meningitis ili encefalitis). Rezultati: West Nile encefalitis je dijagnostikovan kod 127 (78,9%) bolesnika, a West Nile meningitis kod 34 (21,1%) bolesnika. Kod 45,9% bolesnika je registrovana leukocitoza. Vrednosti CRP-a veće od 100 mg/L su zabeležene samo kod bolesnika sa encefalitisom (p= 0,020). Zabeleženo je prosečno 146±171 leukocita po mikrolitru CST, sa lakom predominacijom limfocita (prosečno 52%). Hipoglikorahija je registrovana kod 9,3% bolesnika. Umrlo je 28 (17,4%) bolesnika, svi sa encefalitisom. Vrednosti serumskog CRP-a > 100 mg/L (p= 0,011) i vrednosti proteina u CST > 1 g/L (p= 0,002) bile su nezavisni prediktori smrtnog ishoda kod bolesnika sa WNND. Zaključak: Od WNND najčešće obolevaju stariji muškarci. Prolongirana predominacija neutrofila u CST i hipoglikorahja se mogu povremeno registrovati. Rizik od smrtnog ishoda povećan je kod bolesnika sa encefalitisom, visokim vrednostima serumskog CRP-a i proteinorahje.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
PMC ID: PMC5471641
DOI: 10.1515/jomb-2016-0022
objavljen u SCIndeksu: 04.02.2020.