34例婴幼儿登革热的临床特征分析  

Clinical Characteristic Analysis of 34 Cases of Infant with Dengue Fever

作　　者：林菁[1] 洪文昕[1] 张复春[1] 胡丹[1] 谭丽丽[1] 

机构地区：[1]广州市第八人民医院,广东广州510440

出　　处：《儿科药学杂志》2016年第7期11-14,共4页Journal of Pediatric Pharmacy

基　　金：广东省建设中医药强省立项资助科研课题;编号20151067;广东省科技计划项目;编号2013A020229002

摘　　要：目的:总结34例<3岁婴幼儿登革热的临床特征,为婴幼儿登革热临床诊断提供参考。方法:对2014年9月至12月我院收治的34例<3岁的婴幼儿登革热的临床症状与体征、实验室检查结果、血清免疫学和病原学检查结果、并发症、治疗与转归方面的临床资料进行回顾性分析。结果:所有患儿均有发热,82.4%的患儿发热类型为不规则型;85.3%患儿出现皮疹,合并呼吸道和胃肠道症状较多,较少数出现肝脾肿大;白细胞总数降低患儿占29.4%,血小板降低患儿占41.2%,红细胞比容(HCT)降低患儿占82.4%,凝血酶原时间(PT)缩短患儿占38.2%;丙氨酸氨基转移酶(ALT)轻度升高患儿占8.8%,天冬氨酸氨基转移酶(AST)轻度升高患儿占55.9%;未见伴有总胆红素水平升高患儿;腹部B超、肾功能和心肌酶谱均无异常。发病10 d内,58.8%的患儿DF-Ig M阳性,85.7%为初次感染,24.3%为二次感染,早期检测登革NS1抗原阳性率为29.4%,登革病毒核酸RP-PCR阳性率为32.3%,Ig M检测阳性率为17.6%。11.8%患儿并发支气管炎,20.6%患儿并发肝功能损害,无登革热重症及死亡病例。结论:婴幼儿登革热起病症状较轻、病程短,临床表现为典型登革热为主,合并呼吸道、胃肠道表现及肝功能轻度损害较多,治疗效果好。发病早期应及时检测登革抗原NS1和病毒核酸,有助提高快速诊断率。Objective： To summarize the clinical features of dengue fever in infants under 3 years old,and provide theoretical basis for clinical diagnosis of dengue fever in infants. Methods： Thirty four infants less than 3 years old with dengue fever in our hospital from September to December in 2014 were analyzed retrospectively. We collected clinical symptoms and signs,laboratory test results,serum immunology and pathogenic examination results,complications,treatment and prognosis. Results： All children have a fever,82. 4% of the children with irregular type of fever. 85. 3% children had rash,combined with respiratory and gastrointestinal symptoms more. A few children presented hepatosplenomegaly. White blood cell count decreased in children accounted for 29. 4%,41. 2% children with platelet decrease,82. 4% children with HCT decreased,38. 2% children with PT reduced,8. 8% children with ALT mildly elevated,55. 9% children with AST mildly elevated. Total bilirubin,abdominal ultrasound,renal function and myocardial enzyme spectrum were no abnormal. In 10 days,DF-Ig M of 58. 8% children were positive,85. 7% children were initial infection,24. 3% children were secondary infection,early detection of dengue virus NS1 antigen positive rate was 29. 4%. Nucleic acid of dengue virus positive rate detected by RT-PCR was 32. 3%,positive rate of Ig M was 17. 6%. 11. 8% children with bronchitis,20. 6% with liver function damage,no severe cases of dengue fever and death. Conclusion： Infant with dengue fever onset symptom is lighter,short course of disease,clinical manifestations of classic dengue fever are respiratory and gastrointestinal manifestations with mild damage of the liver function,the treatment effect is good. Detection of dengue NS1 antigen and nucleic acid in early time can help to improve the diagnosis rate.

关 键 词：登革热 婴幼儿 临床特征 

分 类 号：R725.1[医药卫生—儿科]