儿童急性血吸虫病61例临床分析

Clinical analysis of 61 children with acute schistosomiasis Japanica

目的了解儿童急性血吸虫病的特点。方法回顾性分析1986～2003年61例临床确诊为急性血吸虫病的住院儿童的临床资料。结果儿童急性血吸虫病以夏秋季为发病高峰,学龄期男孩多见。所有患儿均有发热,伴呼吸道症状41例(67.2%),消化道症状40例(65.6%),肝肿大52例(85.2%),肝脾均肿大20例(32.8%)。白细胞总数升高51例(83.6%),嗜酸性粒细胞升高49例(80.3%),伴贫血44例(72.1%)。患儿血沉增快89.8%(44/49例);IgG和/或IgA、IgM升高85.4%例(35/41例);肝脏B超异常91.5%43/47例);胸片异常55.6%(30/54例)。误诊率达19.7%。结论儿童血吸虫病临床表现复杂而不典型,近年来发病率呈回升趋势;临床医师需提高对本病的认识,避免误诊误治;吡喹酮是治疗血吸虫病安全有效的首选药物。

Objective To understand the characteristics patterns of schistosomiasis Japanica in children.Methods Clinical data of sixty-one children hospitalized during 1986～2003 with schistosomiasis Japanica were analyzed retrospectively.Results Peak time for childhood schistosomiasis Japanica was in summer and fall,with more common in school age boys.All the patients had fever,and most of them were complicated with respiratory tract symptoms(67.2%),gastrointestinal tract symptoms(65.6%). 52(85.2%)patients had hepatomegaly,of which 20(32.8%)had splenohepatomegaly.White blood cell counts and eosinophil counts were raised in 51(83.6%)and 49(80.3%)children respectively,44(72.1%)were accompanied by anemia.And 89.8% patients had increased erythrocyte sedimentation rate,85.4% had increased immunoglobulin G,A and M levels.91.5% patients had abnormal findings in liver ultrasound examination,and 55.6% were found with abnormal findings in chest X-ray.The misdiagnosis rate was as high as 19.7%.Conclusions The clinical characteristics of childhood schistosomiasis Japanica are atypical and complex.As the mobilidity of schistosomiasis Japanica is increasing in these years.Schistosomiasis Japanica should be understood more deeply for clinician to avoid misdiagnosis.Praziquantel is a safe and effective drug for acute schistosomiasis Japanica.