咽结合膜热所致镜下血尿的临床研究

Microscopic observation on hematuria due to pharyngo-conjunctival fever.

目的研究咽结合膜热所致镜下血尿的临床情况,明确血尿是否为咽结合膜热的常见临床表现之一,探讨血尿出现的早晚与该病病情、病程的关系。方法病例组为22例咽结合膜热患儿,且排除结石、结核、肿瘤、肾小球肾炎等疾病。对照组为同期住院的因其他原因发热的患儿30例,一般情况、病情、病程与病例组基本一致。结果病例组血尿出现率为86.3%,明显高于对照组的6.7%(P<0.01)。其发热、咽充血、扁桃体肿大、眼结膜充血、血尿等临床指征的发生率均在86.3%以上,而其他的症状、体征的发生率均在36.4%以下。血尿的发生率与咽结合膜热的其他典型临床表现的发生率差异无显著性(P>0.05),而与一般的临床表现的发生率差异有显著性(P<0.01)。病例组中有6例在发病3d内出现镜下血尿,均为+++～++++,而且持续时间均超过5d,病程均为7d左右,体温持续在39～41℃之间;而其余13例在发病3d以后出现血尿的患儿,则体温持续在38～39.5℃之间,血尿一般在++以下,持续时间2～3d,病程一般在5d左右。结论血尿是咽结合膜热的常见临床表现之一,血尿出现的早晚与咽结合膜热病程、临床表现的关系密切。

Objective To study the clinical situation of hematuria caused by pharyngo-conjunctival fever, ascertain if hematuria is one of the common clinical manifestations of pharyngo-conjunctival fever and explore the relationship between the early and/or late occurrence of hematuria and the condition and course of the disease. Methods All the 52 patients were divided into treatment group and control group. The treatment group consisted of 22 cases and those with calculus lithiasis, tuberculosis, tumor, glomrulonephritis and other illnesses were excluded and the control group consisted of 30 feverish child patients due to other causes and their general conditions and causes of illness were the same as those in the treatment group. Results Significant differences were observed between the two groups and the incidence of hematuria in the treatment group was over 86.3% obviously higher than that of 6.7% in the control group (P<0.01). The incidence of fever, congestion in the pharynx and conjunctiva, swelling tonsil, hematuria, etc. in the treatment group was over 86.3%, while the incidence of other manifestations and signs was below 36.4%. No significant difference was observed in the incidence of hematuria as compared with that of other typical clinical manifestations of pharyngo-conjunctival fever (P>0.05). Significant difference was observed in incidence of hematuria as compared with those with general clinical manifestations (P<0.01). Hematuria occurred to six patients in the treatment group in three days with a duration of over five days and course of about seven days and a temperature of between 39～41℃. Hematuria was occurred to rest 13 child patients the after three days with a temperature of between 38～39.5℃ lasted two to three days and course of illness of about five days. Conclusion Hematuria is one of the common clinical manifestations of pharyngo-conjunctival fever and the early and/or late occurrence of hematuria is closely associated with the course and clinical manifestation of pharyngo-conjunctival fever.