楊琴 馬紅玲 盧清華

[摘要]目的 探討兒童衛(wèi)氏并殖吸蟲感染并發(fā)多漿膜腔積液的臨床特點(diǎn)，為臨床診斷衛(wèi)氏并殖吸蟲感染所致多漿膜腔積液提供指導(dǎo)。方法 回顧性分析2007年3～12月我院收治的14例衛(wèi)氏并殖吸蟲感染患兒的臨床資料，根據(jù)是否并發(fā)多漿膜腔積液分為單純感染組（7例）和并發(fā)感染組（7例）。觀察兩組的嗜酸性粒細(xì)胞計(jì)數(shù)、血清免疫球蛋白E（IgE）、C反應(yīng)蛋白（CRP）、T淋巴細(xì)胞亞群分化簇3（CD3+）、T淋巴細(xì)胞亞群分化簇4（CD4+）、T淋巴細(xì)胞亞群分化簇8（CD8+）、CD4+/CD8+，且評估兩組的影像學(xué)檢查結(jié)果。結(jié)果 單純感染組與并發(fā)感染組的發(fā)熱溫度、發(fā)熱時(shí)間、咳嗽類型、腹痛、嘔吐等臨床特征比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;并發(fā)感染組的嗜酸性粒細(xì)胞計(jì)數(shù)、血清IgE、CRP均高于單純感染組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;并發(fā)感染組的胸片異常率（100.00%）高于單純感染組（42.86%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;并發(fā)感染組CD3+、CD8+高于單純感染組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;并發(fā)感染組的CD4+、CD4+/CD8+低于單純感染組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 兒童衛(wèi)氏并殖吸蟲感染所致多漿膜腔積液的臨床特征不顯著，為減少誤診或漏診，應(yīng)結(jié)合實(shí)驗(yàn)室檢查、影像學(xué)檢查對患兒實(shí)施診斷。

[關(guān)鍵詞]兒童;衛(wèi)氏并殖吸蟲;感染;多漿膜腔積液;臨床特征

[中圖分類號] R532.22? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1674-4721（2019）7（a）-0158-03

[Abstract] Objective To investigate the clinical characteristics of children with Paragonimus westermani infection complicated with polyserosa effusion， and to provide guidance for clinical diagnosis of polyserosa effusion caused by Paragonimus westermani infection. Methods The clinical data of 14 children with Paragonimus westermani infection admitted to our hospital from March to December 2007 were retrospectively analyzed. According to whether they were complicated with multiple serous effusion， they were divided into simple infection group （7 cases） and complicated infection group （7 cases）. Eosinophil count， serum immunoglobulin E （IgE）， C-reactive protein （CRP）， T lymphocyte subgroup differentiation cluster 3 （CD3+）， T lymphocyte subgroup differentiation Cluster 4 （CD4+）， T lymphocyte subgroup differentiation cluster 8（CD8+）， CD4+/CD8+， and the imaging results of the two groups were evaluated. Results There were no significant differences in fever temperature， fever time， cough type， abdominal pain and vomiting between simple infection group and complicated infection group （P>0.05）. The eosinophil count and serum IgE， CRP of children in complicated infection group were significantly higher than those in simple infection group （P<0.05）. The abnormal rate of chest X-ray in the complicated infection group （100.00%） was higher than that in the simple infection group （42.86%） （P<0.05）. The number of CD3， CD8 of children in complicated infection group was significantly higher than that in simple infection group （P<0.05）. The differentiation cluster CD4 and CD4+/CD8+ of children in infection group were significantly lower than those in simple infection group （P<0.05）. Conclusion The clinical features of polyserosa effusion caused by Paragonimus westermani infection in children are not significant. In order to reduce misdiagnosis or missed diagnosis， it is necessary to combine with laboratory examination and imaging examination to diagnose the children.