儿童感染性急性荨麻疹127例临床分析
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Clinical analysis of 127 cases of pediatric acute urticaria caused by infection
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    摘要:

    目的:了解儿童急性荨麻疹与感染的关系,探讨儿童感染性急性荨麻疹的临床特征。方法:对149例儿童急性荨麻疹住院病例的临床资料进行回顾性研究。结果:(1)149例儿童急性荨麻疹中,感染引起的有127例,占85.2%,以呼吸道感染为主。血常规以白细胞、中性粒细胞、C反应蛋白升高为主,提示可能以细菌感染居多。(2)病毒感染中,柯萨奇病毒阳性率达24.5%,明显高于其他6种常见病毒感染率。(3)皮损特点:皮疹持续时间约0.5~1.0 d;易泛发全身;以环状或地图状风团样丘疹或斑块为主,少数可伴出血或紫癜,部分病例皮疹消退不完全,可遗留地图样淡红色边缘或色素沉着;此外常合并血管性水肿(53.5%);皮肤表现与感染控制情况与否相伴行;病程约7.0~11.0 d;(4)除皮疹外常伴发消化道症状(64.4%);43.5%的患儿伴肌酸激酶同工酶升高;(5)抗过敏的同时加用抗感染药物治疗(7.0~10.0 d)可治愈。结论:(1)感染是儿童急性荨麻疹的最主要原因,可能以细菌感染居多;(2)病毒感染以柯萨奇病毒为主;(3)儿童感染性急性荨麻疹在皮疹方面有其特殊性;(4)常伴发消化道症状,部分可能存在心肌损害;(5)治疗上应重视足够疗程的抗感染治疗。

    Abstract:

    Objective:To investigate the relationship between infection and pediatric acute urticaria and to analyze the clinical charac-teristics of pediatric acute urticaria caused by infection. Methods:Clinical data of 149 patients with acute urticaria were collected from January 2009 to March 20l2 and were analyzed retrospectively. Results:(1)Among 149 cases of pediatric acute urticaria,127 cases(85.2%) was caused by infection,especially respiratory tract infection. Numbers of white blood cell,neutrophile granulocyte and C-reactive protein were increased indicating the bacteria infection. (2)In virus detection,positive rate of coxsackie virus was 24.5%,obviously higher than that of other common viruses. (3)Features of skin lesion:the lesion lasted for 0.5-1.0 d and tended to spread to the whole body;annular or geographic papules and plaques were seen in most patients and a few patients might develop into hemor-rhagic lesions;meanwhile,some lesions faded to leave geographic border or brownish pigmentation;besides,53.5% cases were accom-panied with angioedema;skin manifestations might come with the severity of infection;the duration was about 7.0-11.0 d. (4)64.4% cases were accompanied with digestive symptoms and 43.5% cases were accompanied with increased of creatine kinase-MB;(5)An-ti-allergic agents as well as anti-infective drugs had positive effect. Conclusions:(1)Infection is the main cause of pediatric acute urticaria and the bacteria may dominate the infection. (2)In virus infection,coxsackie virus is the most common. (3)There are some special features in skin lesion of pediatric acute urticaria caused by infection. (4)In fact,quite a few patients are accompanied with di-gestive symptoms and some of which may get myocardial injury. (5)We should attach importance to enough course of anti-infection treatment.

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龚 灵,欧阳莹.儿童感染性急性荨麻疹127例临床分析[J].重庆医科大学学报,2013,(4):438-441

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  • 在线发布日期: 2013-05-16
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