嗜酸性粒细胞和血小板升高在肺吸虫病“积分诊断量表”中的应用价值及文献分析  

Application value of raised eosinophilic granulocyte and platelet count in “the integral diagnosis scale” of lung fluke disease: a case report and literature review

作　　者：张霞 钟炎平[1] 杨军杰 李姗 雷旭 李金科 李芳 李健 杨靖 谭华炳 ZHANG Xia;ZHONG Yan-ping;YANG Jun-jie;LI Shan;LEI Xu;LI Jin-ke;LI Fang;LI Jian;YANG Jing;TAN Hua-bing(Department of Infections Diseases,Institute of Hepatology,Renmin Hospital,Hubei University of Medicine,Shiyan Hubei 442000,China)

机构地区：[1]十堰市人民医院(湖北医药学院附属人民医院)感染性疾病科、肝病研究所,湖北十堰442000 [2]房县人民医院全科医学科

出　　处：《医学动物防制》2021年第9期850-852,共3页Journal of Medical Pest Control

基　　金：湖北医药学院校基金人体重要寄生虫创新团队(FDFR201603);2014年湖北医药学院附属人民医院创新团队项目(201404);2019年十堰市科学技术研究与开发项目计划(19K67)。

摘　　要：目的分析嗜酸性粒细胞(eosinophil granulocyte, EOS)和血小板(platelet, PLT)在肺吸虫病(lung fluke disease, LFD)"积分诊断量表"中的应用价值。方法分析1例"胸背痛6月,间断发热2月,咳嗽25天"患者的诊疗经过。结果患者有生食螃蟹和饮生水史。体检右下肺呼吸音消失,叩诊呈浊音。EOS计数为1.96×10^(9)/L,EOS百分比29.3%,PLT计数466×10^(9)/L;胸部多层螺旋CT提示右侧胸腔积液伴右肺膨胀不全;彩超提示胸腔积液;胸腔积液检验为渗出液,白细胞分类以淋巴细胞为主。LFD"积分诊断量表"积分为12.93分(LFD"积分诊断量表"积分≥9.31诊断LFD),肺吸虫抗原皮试强阳性,临床和病原学均支持诊断LFD。经吡喹酮抗LFD治疗3个疗程后临床症状和体征消失,EOS、PLT恢复正常。结论 EOS和PLT升高在LFD"积分诊断量表"中具有重要价值,并可以作为疗效观察指标。Objective To research on application value of raised eosinophilic granulocyte(EOS) and platelet count(PLT) in “the integral diagnosis scale” of lung fluke disease(LFD),enhance the level of the diagnosis and treatment of paragonimiasis.Methods A case of LFD with cough for 25 days, intermittent fever for 2 months, stethalgia and dorsalgia for 6 months as its main clinical manifestation was reported.Results The patient has a history of eating raw crabs and drinking raw water.On physical examination, the respiratory sound in the right lower lung disappeared, and the percussion sound was voiced.Laboratory examination of peripheral blood: EOS 1.96×10^(9)/L,EWBC(EOS%) 29.3% and PLT 466×10^(9)/L respectively.Multislice spiral CT of the chest shows right pleural effusion with right lung insufficiency;color duplex ultrasound suggests pleural effusion;pleural effusion was detected as exudate, and the leukocyte classification was dominated by lymphocytes.The patient′s score from the integral diagnosis scale of LFD was 12.93(≥9.31).The intradermal reaction for LFD antigen was strongly positive, and the diagnosis of LFD was supported by clinical and etiological data.After three courses of anti-LFD treatment by praziquantel, EOS and PLT gradually returning to normal levels, the patient′s clinical symptoms and signs disappeared significantly.Conclusion Dialectical analysis of PLT and EOS is the key process in the “the integral diagnosis scale” of LFD.EOS and PLT are important indicators to observe the curative effect.

关 键 词：嗜酸性粒细胞 血小板计数 肺吸虫病 积分诊断量表 诊断 

分 类 号：R532.2[医药卫生—内科学]