儿童黑热病26例临床分析

Clinical analysis of children kala-azar in 26 cases

目的分析26例儿童黑热病临床和实验室特点,以提高对儿童黑热病的认识。方法回顾性分析2002年1月—2010年12月新疆医科大学第一附属医院儿科收治的26例儿童黑热病的临床及实验室资料,对其进行总结。结果 (1)26例黑热病患儿早期临床表现多不典型,以发热(100.00%)、乏力(73.07%)、纳差(88.46%)、咳嗽(69.23%)为主要临床表现,查体主要以贫血貌(84.62%)、精神萎靡(84.62%)、淋巴结肿大(80.77%)、脾肿大(73.07%)、肝肿大(73.07%)为主;(2)脾肿大程度与血细胞降低程度呈正相关;(3)20例骨髓涂片检查到利杜体,另6例结合免疫检测提示阳性。结论儿童出现不规则发热、消瘦、进行性脾脏肿大及全血细胞减少时应考虑到黑热病,早期进行骨髓检查结合免疫检测可提高诊断的准确率,减少误诊和漏诊。

Objective To analyze the clinical and laboratory features of childhood Kala-azar and improve the understanding of this disease.Methods From January 2002 to December 2011,26 cases of Kala-azar from the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.Results（1） The main clinical feasures of childhood Kala-azar were atypic,which were fever（100.00%）,cough（69.23%）,the main symptoms were anaemia appearance,listlessness,enlargement of lymph nodes,splenomegaly,hepatomegaly;（2） Splenomegaly degree and blood cells reduce degree were positively correlated;（3） 20 cases inspected the Leishman-Donov ani body from the bone marrow smear,6 patients with immune testing positive for tips.Conclusion If patients were found irregular fever,emaciation,progressive splenomegaly and pancytopenia,we should take into consideration this disease,as early as proceeding the bone marrow examination,in order to reduce the misdiagnose and missed diagnosis.