血常规结果在常见传染病鉴别诊断中的应用

Differential diagnostic value of blood routine tests for several kinds of common infectious disease

目的 探讨血常规结果对伤寒、肾综合征出血热（HFRS）、疟疾、传染性单核细胞增多症（IM）等4种传染病的鉴别诊断意义。方法 收集2000年5月-2004年5月期间血常规资料；伤寒患者58例、HFRS患者47例、疟疾患者23例、IM患儿54例、呼吸道感染患者38例。对血常规结果进行分析。收集健康成人及儿童静脉血共70份进行血常规检查作为正常对照组。结果 伤寒患者血常规显示白细胞计数正常或偏低，嗜酸性粒细胞（EOS）消失；HFRS患者血常规显示血小板计数〈100×10^9／L，多数病例白细胞分类可见异型淋巴细胞（简称异淋），但是异淋比例多在15％以下；疟疾患者血常规显示血红蛋白轻度减低，血小板计数〈100×10^9／L，多数病例血涂片可直接找到疟原虫；IM患儿血常规显示淋巴细胞比值升高，异淋易见，多数病例异淋比例〉10％。结论 血常规检查结果可以作为伤寒等4种传染病的辅助诊断及鉴别诊断指标。

Objective To explore the differential diagnostic value of blood routine tests for typhoid fever, hemorrhagic fever with renal syndrome （HFRS）, malaria and infectious mononucleosis （IM）. Methods During May 2000 to May 2004 blood routine data of 58 typhoid fever patients,47 HFRS patients,23 malaria patients,54 IM patients and 38 respiratory tract infection patients were collected. Same kind data were also collected from healthy adults and children as normal control. Results Typhoid fever patients showed that leukocyte count was normal or low, eosinophils （EOS） was not detected; HFRS patients showed that platelet was less than 100 × 10^9/L,atypical lymphocyte could be found in leuko-cyte differential count of most case;proportion of atypical lymphocyte was less than 15%. Malaria patients showed that hemoglobin decreased lightly, platelet was less than 100 × 10^9/L, plasmodium could be found in blood smear. IM patients showed that proportion of atypical lymphocytes increased,proportion of atypical lymphocytes in most cases was more than 10%. Conclusions Blood routine tests are useful in the diagnosis of these kinds of infectious disease.