幼儿急疹的鉴别诊断情况评价  

Evaluation of differential diagnosis of exanthem subitum

作　　者：李佳森 王丽菲 LI Jia-sen;WANG Li-fei(Department of Pediatrics,Nan'an Honglai Central Health Center,Quanzhou 362331,China)

机构地区：[1]南安市洪濑中心卫生院儿科,362331 [2]南安市洪濑中心卫生院内科,362331

出　　处：《中国现代药物应用》2024年第14期63-66,共4页Chinese Journal of Modern Drug Application

摘　　要：目的研究幼儿急疹的鉴别诊断情况。方法择取27例幼儿急疹患儿,回顾性分析所有患儿的一般资料(发病年龄)、临床症状与体征、实验室检查、治疗与预后情况。结果患儿年龄以8~13月龄居多,比例为74.07%(20/27)。热程以3 d居多,比例为62.96%,发热峰值在39.0~39.9℃的最多;在病程第4天出疹的比例最高,为59.26%。还伴有咽部不适、咳嗽、鼻塞、流涕、打喷嚏等症状。淋巴结肿大(88.89%)为最常见体征,热退后1 d内出疹比例为92.59%,多为皮疹典型症状(77.78%)。实验室检查结果显示,白细胞计数低于正常范围[(11.0~12.0)×10^(9)/L]共12例,C反应蛋白异常共5例;病程第1、7天,患儿的白细胞计数、中性粒细胞计数均高于第4天(P<0.05),第7天的白细胞计数与第1天数据相近(P>0.05),第7天的中性粒细胞计数低于第1天(P<0.05);中性粒细胞/淋巴细胞比值随着病程的增加而降低,不同时间点数据对比差异明显(P<0.05)。大便常规结果异常率为18.52%,心肌酶谱异常率为33.33%,85.19%的患儿存在病原体感染。所有患儿均在1周内治愈且预后良好。结论结合临床症状体征以及实验室检查结果能够对幼儿急疹进行准确地诊断。Objective To study the differential diagnosis of exanthem subitum.Methods 27 cases of exanthem subitum were selected and retrospectively analyzed for general information(age of onset),clinical signs and symptoms,laboratory tests and treatment prognosis of all children.Methods The age of the children was mostly 8-13 months old,with a proportion of 74.07%(20/27).The duration of fever was 3 d in most cases,with a proportion of 62.96%,and the fever peaks was 39.0-39.9℃in most cases;the highest proportion of rashes appeared on the 4th day of the course of the disease,with a proportion of 59.26%.It was also accompanied by pharyngeal discomfort,cough,nasal congestion,runny nose,sneezing and other symptoms.Lymph node enlargement(88.89%)was the most common sign,and the proportion of rashes within 1 d after the fever subsided was 92.59%,mostly typical of rashes(77.78%).Laboratory findings showed that the white blood cell count was below the normal range[(11.0-12.0)×10^(9)/L]in a total of 12 cases,and C-reactive protein was abnormal in a total of 5 cases;On days 1 and 7 of the disease course,the children's white blood cell counts and neutrophil counts were higher than those on day 4(P<0.05),and the white blood cell count on day 7 was similar to the data on day 1(P>0.05);Neutrophil counts on day 7 were lower than that on day 1(P<0.05).The neutrophil/lymphocyte ratio decreased with increasing disease duration,and the difference was significant when comparing data at different time points(P<0.05).The rate of abnormal stool routine was 18.52%,the rate of abnormal myocardial enzymes was 33.33%,and 85.19%of the children had pathogenic infections.All children were cured within 1 week and had a favorable prognosis.Conclusion The combination of clinical signs and symptoms as well as laboratory findings can accurately diagnose exanthem subitum.

关 键 词：幼儿 急疹 鉴别诊断 

分 类 号：R725.1[医药卫生—儿科]