非肝炎病毒感染性肝炎患儿临床诊治分析

Clinical diagnosis and treatment of children with non-hepatitis virus infection

目的探讨儿童发生非肝炎病毒感染相关性肝炎的诊断及治疗效果,对临床发生非肝炎病毒感染性肝炎患儿的诊断和治疗提供指导。方法采用回顾性分析方法对2009年1月-2012年8月在感染科住院治疗的143例患儿,非肝炎病毒感染性肝炎的临床特征及诊断和治疗结果。结果 143例非肝炎病毒感染相关性肝炎患儿的临床症状主要表现为发热占61.54%、纳差占46.35%、腹泻腹胀占32.17%、咳嗽占31.47%、恶心呕吐占29.37%;患儿的临床体征主要表现为肝脏肿大占30.77%、扁桃体肿大占28.67%、淋巴结肿大占23.08%、脾大占18.18%;入院时指标谷丙转氨酶(ALT)、谷草转氨酶(AST)异常分布率最高,分别为92.13%、88.11%,出院时分别为6.99%、5.59%;治疗前143例患儿的ALT、AST水平分别为(365.67±38.44)IU/L、(268.93±36.72)IU/L,治疗后分别为(159.53±26.74)IU/L、(84.92±9.33)IU/L,治疗后ALT、AST均明显的下降且治疗前后差异有统计学意义(P<0.05)。结论儿童非肝炎病毒感染相关性肝炎的临床表现与病毒感染相关性肝炎的临床表现非常相似,要综合实验室各种指标及病原学检查,并进行综合治疗。

OBJECTIVE To explore the diagnosis of the children with viral infection‐associated hepatitis and observe the therapeutic effect so as to provide guidance for clinical diagnosis and treatment of the children with hepatitis vi‐rus infections .METHODS A total of 143 children with hepatitis virus infections who were hospitalized the infection control department from Jan 2009 to Aug 2012 were enrolled in the study ,then the clinical characteristics and the results of diagnosis and treatment of the participants were retrospectively analyzed .RESULTS Of the 143 children presenting various clinical manifestations ,61 .54% had fever ,46 .35% had loss of appetite ,32 .17% had diarrhea and abdominal distension ,31 .47% had cough ,and 29 .37% had nausea and vomiting .As for the clinical signs of the children with viral infection‐associated hepatitis ,30 .77% had hepatomegaly ,28 .67% had swollen tonsils , 23 .08% had lymphadenopathy ,and 18 .18% had splenomegaly .The abnormal rates of alanine aminotransferase （ALT） （92 .13% ） and aspartate aminotransferase （AST） （88 .11% ） were the highest at the admission to the hos‐pital and were respectively 6 .99% and 5 .59% at the discharge from the hospital .The levels of ALT and AST of the 143 children were respectively （365 .67 ± 38 .44）IU/L and（268 .93 ± 36 .72）IU/L before the treatment and were respectively （159 .53 ± 26 .74）IU/L and（84 .92 ± 9 .33）IU/L after the treatment ;the levels of ALT and AST were significantly reduced after the treatment （P〈0 .05） .CONCLUSION The clinical manifestations of the children with non‐viral infection‐associated hepatitis are so similar to the clinical manifestations of the children with viral in‐fection‐associated hepatitis .It is necessary to conduct the comprehensive treatment based on the clinical laboratory indicators combined with etiological examination .