柯萨奇病毒感染临床表现的多样性.docxVIP

柯萨奇病毒感染临床表现的多样性 【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、咳嗽、腹泻、咽痛，其 次是胸闷心悸、一过性瘫痪、头痛、呕吐。 最常见的体征是肝、脾、淋巴结肿大，其次 是皮疹、肺部干湿 口罗音、咽部疱疹、口 腔黏膜溃疡。实验室检查心肌酶升局最常见， 其次是肝功能异常及末梢血发现异形淋巴 细胞，另外粒细胞减少，尿检异常。 源多 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、巨细胞病 毒、支原体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 Retrospective cohort study was done to investigate clinical manifestations and laboratory findings of Coxsackie virus The incidence of Cox-sackie virus infection was high in the summerand was present %of the was found in52%, diarrhea % sore throat % oppressive sensation over the chest and palpitation % , transient paralysis % , headache and vomiting %.Signs of hepatomegaly ， splenomegaly and enlarged lymph nodes were showed % , % %of the cases respectively ， rashes % dry and wet rale of the lung % ， bleb of throat % ， oral ulcer %.Labo-ratory tests showed that CK-MBand LDHwere elevated %and52% and ALT and bile acid were elevated %%.There were atypical lymphocytes of distal blood % , leucopenia %and abnormal routine urine %.Tests suggested multiple organs and multiple systems disfunction %.Conclusions There are various clinical manifestations of Coxsack-ie virus typical form , it was an important cause of infectious mononucleosis-like syndrome and children s s a possible trigger of immune organs and multiple systems disfunction are s necessary to differentiate with Epstein-Barr virus , cytomegalovirus , mycoplasmaand septicaemia. 【Key words】Coxsackie virus;Multiple organs and multiple systems disfunction;Young child 柯萨奇病毒属于肠道病毒，是一种小 RNA 病毒。因1948年在美国纽约州柯萨奇地区 分离出而得名。柯萨奇病毒感染是临床常见 病，过去由于血清免疫学检测未普遍开展， 人们对该病的认识受到局限。近年来我们开 展了同时测定血清柯萨奇病毒抗原和抗体， 为提高对柯萨奇病毒感染的诊断水平， 本研 究将1999年9月至2006年8月明确诊断的 98例患儿临床特点回顾分析如下。 1对象和方法 病例来源1999年9月?2006年8月在儿 科住院、被疑为病毒感染的患儿 416例，包 括发热待查、呼吸道感染、传染性单核细胞 增多症、腹泻、心肌炎、脑炎、瘫痪性疾病 等病种。其中男性275例，女性141例。