幼儿急疹合并粒细胞减少或缺乏120例分析  

Analysis of 120 cases of exanthema subitum with granulocytopenia or agranulocytosis

作　　者：罗建峰[1] 吴华杰[1] 石曌玲[1] 钱新宏[1] 

机构地区：[1]第四军医大学西京医院儿科,陕西西安710032

出　　处：《中国妇幼健康研究》2016年第2期268-269,共2页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨幼儿急疹的临床特征及实验室特点，以便早期诊断及正确治疗。方法收集2013年1月至2014年10月西京医院120例幼儿急疹病例资料，对其起病特点、临床表现、血常规、C反应蛋白、血沉、丙氨酸氨基转移酶及天门冬氨酸转氨酶进行回顾性分析。结果在120例病例中，以春季和夏季发病率居高，分别占30．0％和35．0％。所有患儿的血常规均表现为白细胞总数降低，平均为（5．35±2．32）×10^9／L；所有患儿均有粒细胞数降低，其中46例（38．3％）为粒细胞减少（〈1．5×10^9／L），74例（61．7％）为粒细胞缺乏（〈0．5×10^9／L），最低者为0．09×10^9／L；所有患儿血沉、C反应蛋白均正常，有80例患儿天门冬氨酸转氨酶轻度升高。结论幼儿急疹的临床特点为起病急、持续高热、精神好，耳后、枕后淋巴结肿大，实验检查发现多合并存在粒细胞减少或缺乏，根据这些特点，有助于早期诊断。Objective To explore the clinical presentations and laboratory characteristics of infants with exanthema subitum （ES） so as to make early diagnosis and deliver appropriate treatment. Methods One hundred and twenty cases of ES were collected in Xijing Hospital during the period of January 2013 to October 2014. Retrospective analyses were conducted on their onset characteristics, clinical manifestations, blood routine examinations, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, alanine aminotransferase （ALT） and aspartic transaminase （AST）. Results Among the 120 cases, the incidences of ES were high in spring and summer, accounting for 30.0% and 35.0%, respectively. Blood routine examinations of all infants showed decreased white blood ceils （WBC） count, with their average being （5.35 ±2.32） × 10^9/L. Besides, neutrophil counts of all infants were also decreased, among which 46 cases （38.3%） were granulocytopenia （ 〈 1.5×10^9/L） while 74 （61.7%） were agranulocytosis （ 〈0.5 × 10^9/L）. The lowest level was 0.09 × 10^9/L. Values of ESR and CRP of all infants were in the normal range. Levels of AST were slightly elevated in 80 cases. Conclusion ES is characterized by acute onset, persistent fever, good spirit, and accompanied by enlargement of retroauricular and occipital lymph nodes. Meanwhile, laboratory tests show that ES is usually accompanied with granulocytopenia or agranulocytosis. Based on preceding observations, early diagnosis can be made.

关 键 词：幼儿急疹 临床特征 粒细胞减少或缺乏 诊断 治疗 

分 类 号：R722[医药卫生—儿科]