柯萨奇病毒感染临床表现多样性.docVIP

柯萨奇病毒感染临床表现多样性 　【摘要】 目的 探讨小儿柯萨奇病毒感染的临床特点。 方法 回顾分析98例柯萨奇病毒感染的临床表现及实验室资料。 结果 柯萨奇病毒感染夏秋季节发病率高，最常见的症状是发热（90.8%）、咳嗽（52.0%）、腹泻（29.6%）、咽痛（22.4%），其次是胸闷心悸（13.3%）、一过性瘫痪（8.2%）、头痛、呕吐（7.1%）。最常见的体征是肝、脾、淋巴结肿大（分别为31.6%、27.6%、17.3%），其次是皮疹（12.2%）、肺部干湿 口罗 音（11.2%）、咽部疱疹（10.2%）、口腔黏膜溃疡（7.1%）。实验室检查心肌酶升高最常见（CB-MB升高占27.6%，LDH升高占52%），其次是肝功能异常（ALT升高占16.3%，胆汁酸升高占22.4%）及末梢血发现异形淋巴细胞（19.4%），另外粒细胞减少（11.2%），尿检异常（14.3%）。19.4%有多器官多系统损害。 结论 柯萨奇病毒感染临床表现复杂多样，除表现为较典型综合征外，亦是类传染性单核细胞增多症、小儿肺炎的重要病原，免疫性疾病的始动环节，常见多器官多系统损害。需与E-B病毒（EBV）、巨细胞病毒（CMV）、支原体（MP）感染及败血症相鉴别。X 【关键词】 柯萨奇病毒;多器官多系统损害;小儿 【Abstract】Objective To investigate the clinical features of Coxsackie virus infection in children.Methods Retrospective cohort study was done to investigate clinical manifestations and laboratory findings of Coxsackie virus in98children.Results The incidence of Cox-sackie virus infection was high in the summer and fall.Fever was present in90.8%of the cases.Cough was found in52%，diarrhea in29.6%，sore throat in22.4%，oppressive sensation over the chest and palpitation in13.3%，transient paralysis in8.2%，headache and vomiting in7.1%.Signs of hepatomegaly，splenomegaly and enlarged lymph nodes were showed in31.6%，27.6%，17.3%of the cases respectively，rashes in12.2%，dry and wet rale of the lung in11.2%，bleb of throat in10.2%，oral ulcer in7.1%.Labo-ratory tests showed that CK-MB and LDH were elevated in27.6%and52%，and ALT and bile acid were elevated in16.3%and22.4%.There were atypical lymphocytes of distal blood in19.4%，leucopenia in11.2%and abnormal routine urine in14.3%.Tests suggested multiple organs and multiple systems disfunction in19.4%.Conclusions There are various clinical manifestations of Coxsack-ie virus infection.Besides typical form，it was an important cause of infectious mononucleosis-like syndrome and children’s pneumonia.It’s a possible trigger of immune diseases.Multiple organs and multiple systems disfunction are common.It’s necessary to differentiate with Epstein-Barr virus（EBV），cytomegalovirus（CMV），mycoplasma（MP）a