摘要目的 总结疱疹性咽峡炎的热程、血常规、C反应蛋白(CRP)特点及抗生素治疗效果.方法 对河南省人民医院2018年5月至6月夜间就诊的166例疱疹性咽峡炎患儿的临床资料进行回顾性分析.结果 5、6月份儿科夜间急诊共收治3092例患儿,其中疱疹性咽峡炎患儿166例,占5.37％;有明确接触史者81例(48.8％);166例患儿中男89例(53.6％),女77例(46.4％);年龄5个月～9岁;有发热表现者165例,1例仅咽痛;热程(1.96±0.85)d;166例中有完整血常规+CRP检查结果者97例(58.4％),其中白细胞升高73例(75.3％),中性粒细胞计数增高83例(85.6％);淋巴细胞计数增高39例(40.2％);单核细胞计数增高83例(85.6％);CRP增高60例(61.9％),其值为(26.86±14.29)mg/L;应用抗生素治疗者85例(51.2％);166例中合并肺炎1例,水痘1例,均治愈,无重症患儿.应用抗生素组与未用抗生素组热程比较差异未见统计学意义(P>0.05);CRP增高组与CRP正常组热程比较差异有统计学意义(P<0.05).结论 5、6月份为疱疹性咽峡炎高发期,近一半患儿有接触史,传染性强.血常规中白细胞、中性粒细胞及单核细胞计数增高较常见;CRP增高亦较常见,热程较CRP正常组长;应用抗生素后热程变化不大,提示抗生素治疗无效.

abstractsObjective To summarize the characteristics of heat stroke, blood routine, C reactive protein ( CRP ) and antibiotic treatment effect of herpangina. Methods The clinical data of 166 herpangina children from May 2018 to June 2018 in Henan Provincial People's Hospital who were diagnosed at night were retrospectively analyzed. Results In May and June, 3092 children were emergently admitted to the Department of Pediatrics at night. Among these children, 166 children were diagnosed with herpangina, accounting for 5. 37％;81 children had a clear history of contact, accounting for 48. 8％. Among the 166 children, 89 children were boys ( 53. 6％) , and 77 children were girls (46. 4％) . The age of these children was five months to nine years old. A total of 165 children had fever, and one child had only sore throat. The course of fever was ( 1. 96 ± 0. 85 ) days. A total of 97 children (58. 4％) had complete routine blood test and CRP examination results, among these children, 73 children (75. 3％) had increased leucocyte, 83 children (85. 6％) had increased neutrophil count, 39 children (40. 2％) had increased lymphocyte count, 83 children (85. 6％) had increased monocyte count, and 60 children (61. 9％) had elevated CRP [the value was (26. 86 ± 14. 29) mg/L]. Eighty-five children ( 51. 2％) were treated with antibiotics. Among these 166 children, one child was complicated with pneumonia and one children was complicated with chickenpox, and both of them were cured, and no one become severe. The difference in the course of fever between the children with and without antibiotics was not statistically significant ( P>0. 05 ) . The difference in the course of fever between the elevated CRP group and normal CRP group was statistically significant ( P< 0. 05 ) . Conclusions May and June are high-incidence seasons of herpangina. Nearly half of the children have a history of contact, and the disease is severely infectious. In routine blood indexes, the counts of white blood cells, neutrophils and mononuclear cells are frequently increased, and the increase in CRP level is also common. The course of fever is longer in children with elevated CRP than that in normal children. There is little change in the course of fever after the application of antibiotics, suggesting that the treatment of antibiotics is ineffective.