广州市2014年登革热暴发疫情中小儿登革热病例临床特征  

Clinical features of Dengue fever in children epidemic in Guangzhou during 2014

作　　者：喻田甜[1] 罗菲[2] 刘嘉欣 郭红霞[1] 马玉玲[1] 罗雪[1] 叶楠[1] 王源[1] 谭雨龙[1] 林辉[1] 陈晓刚[2] 李晋涛[1] 

机构地区：[1]第三军医大学热带医学研究所,重庆400038 [2]广州中医药大学第一附属医院,广东广州510405 [3]广东省中西医结合医院,广东佛山528200

出　　处：《中国热带医学》2016年第3期273-276,共4页China Tropical Medicine

摘　　要：目的描述小儿登革热病例的临床特征,为小儿登革热患者的早期诊断及时治疗提供参考依据。方法回顾性分析广州某三甲医院在2014年8月30日至10月31日期间,明确诊断、小于14岁的全部住院登革热病例的临床资料。结果共31例小儿普通型登革热病例纳入分析,其中男女比例为15：16,平均年龄（7.65±4.28）岁（1～13岁）,平均住院时间为（5.48±2.38）d（2～15）d。临床症状发生率前5位分别为：发热（100%,31/31）、皮疹（67.74%,24/31）、咳嗽（38.71%,12/31）、淋巴结肿大（32.26%,10/31）和关节/肌肉痛（35.48%,11/31）。77.42%（24/31）的病例登革Ig M呈现阳性;48.39%（15/31）的病例伴有肺炎支原体Ig M抗体阳性;分别有96.77%（30/31）和35.48%（11/31）的病例出现白细胞和血小板计数降低;分别有67.74%、12.90%和51.61%的病例分别出现AST、ALT以及肌酸激酶异常;约1/3的病例出现血钙和血钾异常。结论小儿登革热病例临床表现及实验室检测指标特征与成人病例存在一定差异,临床医生应重视小儿登革热病例的鉴别诊断。Objective To describe the clinical features of dengue fever in children,and to provide a reference to earlydiagnosis and treatment for patients of this disease. Methods Clinical data of dengue fever inpatients were analyzedretrospectively,cases aged under 14 year-old with positive diagnosis and hospitalized in a first class hospital in Guangzhoufrom Aug. 30 th to Oct. 31 st,2014. Results A total of 31 children diagnosed with ordinary dengue fever were recruited foranalysis,with male to female ratio of 15：16,the mean age of（7.65±4.28）years（1~13 years old）,and the average days ofhospitalization were（5.48±2.38）days（2~15 days）. The top five clinical symptoms with high frequency were fever（100%,31/31）,rash（67.74%,24/31）,cough（38.71%,12/31）,swollen lymph node（32.26%,10/31）,and arthralgia or myalgia（35.48%,11/31）. Among all the patients,77.42%（24/31）were tested positive for dengue specific antibody Ig M,and 48.39%（15/31）were tested positive for Ig M antibody to Mycoplasma pneumoniae. Leucocyte and blood platelet counts decreased in 96.77%（30/31）and 35.48%（11/31）of the patients,respectively. The abnormal rates of AST,ALT and CK（creatine kinase）were67.74%,12.90% and 51.61%,respectively. About 1/3 patients were detected with abnormal serum calcium and potassium.Conclusion There were differences in clinical features and laboratory indicators of dengue fever between children and adultsto some degree. Thus,clinicians should pay attention to the identification and diagnosis of dengue fever in children.

关 键 词：登革热 小儿 临床特征 

分 类 号：R373.33[医药卫生—病原生物学]