儿童中性粒细胞减少症的临床特点及病程相关性分析

目的探讨儿童中性粒细胞减少症的致病因素、临床表现和病程特点。方法回顾性分析儿科门诊及急诊确诊为中性粒细胞减少症83例患儿的临床资料。结果发病因素:男女比例为1.37?1;中位年龄为2.4岁;所有病例均以感染性疾病为首诊原因,其中初诊为上呼吸道感染最常见,其次为上呼吸道感染合并腹泻、口腔溃疡,其他疾病有手足口病、幼儿急疹、腹泻病、口腔炎、支气管炎、支气管肺炎等;所有患儿均有用药史,有据可查与患儿中性粒细胞减少的发生直接相关的药物主要为抗生素及解热镇痛药等。临床特点:全部病例均有发热,其他症状有面色苍白、精神萎靡、皮疹等;病程最短者2d,最长者达2个月,>7d者达67.5%,平均病程15.4d。治疗:一周内治愈率为79.52%;两周内治愈率达95.18%。结论儿童中性粒细胞减少症可由多种感染性疾病引起,其中以上呼吸道感染单发及合并其他感染最为多见;其次是以抗生素及解热镇痛等为主的药物影响;临床上以持续低热或反复发热、又或在病程中突发高热为主要特征,病程较长(>7d)者多见,预后良好。

Objective To study the neutropenia of pathogenic factors, clinical manifestations and course characteristics. Methods Retrospective analysis of pediatric out-patient clinics and hospital emergency room diagnosed with neutropenia in children with 83 cases of clinical data. Risk factors ： male ratio of 1.37 ： 1 ; in the median age of 2.4 years of age; of all cases of infectious diseases are the reasons for the US-led clinic, which diagnosed as upper respiratory tract infection the most common, followed by upper respiratory infection combined diarrhea, oral ulcers, other diseases of hand foot mouth disease, measles exanthema, diarrhea, stomatitis, bronchitis, bronchial pneumonia, etc; all children have a history of drug use, well documented with children with neutropenia is directly related to the occurrence of drug mainly antibiotics and analgesics, such as fever. Clinical characteristics ： All patients had fever and other symptoms are pale, make them apathetic, rash,etc; course： minimum 2 days, the longest continuous period of up to 2 months, 〉 7 days, as much as 67.5 percent, with an average course of 15.4 days. Treatment： one week cure rate was 79. 52% ; within two weeks the cure rate of 95.18% ,. Conclusion Children neutropenia may be caused by a variety of infectious diseases, including respiratory tract infections for more than the combined single and most other infections found ; followed by antibiotics and antipyretic analgesic is mainly the influence of drugs, etc ; clinical sustained or repeated low heat, or in the course of the main features of sudden high fever, longer duration （ 〉 7 days） more see ; prognosis is good.