| Summary: | 碩士 === 高雄醫學大學 === 醫學研究所碩士班 === 93 === 英文摘要
Background and Purpose:
We investigated the relationship between dengue fever (DF), dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), and diabetes mellitus(DM) in southern Taiwan.
Methods:
This is a retrospective study of patients serologically proved at a university hospital during an outbreak of DF in Taiwan in 2002 , including OPD and admission patients.
Results:
There are total 644 patients, 411 of them are DF patients and 233 are DHF/DSS/Death patients. 65 of them are DM patients, DM patients are older(59.51±9.87 v.s. 46.23±18.05 years ， p<0.001) ， more obese (BW 67.38±11.76 v.s. 63.52±14.3 Kg，p=0.025), had more HTN【32/65 (49.23%) v.s.
100/579 (17.27%)，p<0.001】；and old CVA history【7/65(10.77%) v.s. 14/579(2.42 ％ ) ， p<0.001 】； more ECG ischemia finding(%) 【13/65(20%)v.s.31/579 (5.35%), p<0.001】, more hospitalization rate【57/65(87.69%) v.s.
430/579(74.27%) ， p=0.017 】。Higher WBC count on day 4 after admission(6.53±4.82 v.s. 5.07±3.28 *103/μL，p=0.042)，and recovery WBC count(6.41±1.68 v.s. 5.69±2.08*103/μL， p=0.018 ） ， lower recovery monocyte
( 8.25±2.67 v.s. 10.36±6.68%,p=0.025), lower PLT count at ER (54.54±51.69 v.s.86.58±63.4*103/μ，p<0.001), PLT-day-2(43.98±44.09 v.s. 64.52±45.06*103/μL，p=0.002)，and PLT day-3(43.86±35.75 v.s. 62.72±51.21*103/μL，p=0.012)，
Higher plasma fibrinogen level(428.83±154.6 v.s. 334.41±119.2mg/dl ，p=0.027)，Multiple logistic regression analysis revealed after adjusted for age and previous dengue history, male gender (Odds ratio=1.53 ， 95% Confidence Interval=1.03~2.77，p=0.037)and diabetes(Odds ratio=2.11，95% Confidence Interval=1.13~3.93，p=0.019)are two risk factors for DHF& DSS& death. In diabetic patients, DM duration is a risk factor for DF severity (10.44±8.15 v.s.6.33±5.26 years ， p=0.017) ， but neither blood sugar(222.86±110.36 v.s.209.04±95.09 mg/dl，p=0.596)nor HbA1c(8.49±1.64 v.s. 8.82±2.18 %，p=0.580)is，The mortality rate between DM and non-DM groups is no difference.【3/65(4.62%) v.s. 8/579(1.38%)，p=0.056】.
Conclusion:
DM and male gender are two risk factors for the development of DHF/ DSS. DM duration is an important risk factor for DF severity in diabetic patients.
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