外周淋巴细胞检测对手足口病的诊断价值

目的探讨外周淋巴细胞检测在手足口病患儿诊断指导中的价值。方法对本院于2012年4～7月的68例住院手足口病患儿,检测两组外周白细胞数值,根据检测数据参考值随机分成两组,白细胞增高组（增高组）38例和白细胞正常组（正常组）30例。两组患儿均予喜炎平或炎琥宁、痰热清、利巴韦林及水溶性维生素对症治疗,白细胞明显增高或CRP明显增高者予抗生素治疗,主要是常规用头孢呋辛钠,其中对头孢类过敏者用克林霉素常规量治疗。结果白细胞增高组与白细胞正常组相比,增高组治疗前后白细胞下降明显。正常组治疗后白细胞平均数稍有上升,中性粒细胞平均数也明显下降,而淋巴细胞平均数则明显增高。两组疗效比较,增高组治愈出院时间缩短,两组差异有统计学意义（P〈0.01）;而增高组平均体温恢复时间则长于正常组,两组差异有统计学意义（P〈0.01）。结论该方案治疗的手足口病患儿,两组治疗后白细胞平均数差异有统计学意义,但数值接近;增高组显著下降,正常组则稍有上升;其中正常组以中性粒细胞平均数下降显著,淋巴细胞平均数变化不大。同时正常组粒细胞显著下降,而淋巴细胞则显著上升。增高组外周血细胞变化以粒细胞降低为主,不完全符合病毒感染的常见特征;而正常组以淋巴细胞增高变化为主,比较符合病毒感染常见特征。

The diagnostic value of detecting peripheral lymphocytes of the hand,foot and mouth disease

Objective To investigate the value of the peripheral lymphocytes detection in the guiding children patients with hand,foot and mouth disease（HFMD）.Methods 68 cases of children patients with HFMD hospitalized for observation during April to July in 2012 were tested the peripheral white cell count.The test data were randomly divided into two groups according to the reference value,including 38 cases of the leukocyte group（increased group） and 30 cases of the white blood cells（normal group）.The numerical changes of peripheral lymphocytes in the two groups before and after treatment as well as the evolution and transformation of the indicators were observed,and we explored the value of the results for guiding clinical diagnosis of HFMD.The two groups of children were correspondingly treated with Xiyanping Yanhuning Tanreqing ribavirin and water-soluble vitamin symptomatic,and those whose white blood cells or CRP significantly increased were given antibiotic,mainly cefuroxime sodium for routine,treatment,in which those who were allergy to cephalosporins were given a conventional amount of clindamycin treatment.Results Compared with the normal white blood cell group,the leukocyte white blood cells after the treatment decreased significantly in the increased group compared with that before the treatment,in which the neutrophils mainly decreased.While the lymphocytes decreased slightly.After treatment,The mean of white blood cell in the normal group increased slightly after the treatment,while the average number of neutrophils decreased and mean of lymphocyte became significantly higher.Comparing the therapeutic effect of the two groups,the cure time of the increased group was shortened,and the statistical difference of the two groups was significant（P〈0.01）;While the average body temperature recovery time of the increased group was longer than that of the normal group,and the statistical difference of the two groups was significant（P〈0.01）.Conclusion The difference of the average number of white blood cell between the two groups after the children HFMD patients being treated with this program has statistical value,but the results are close;The increased group has increased significantly and the normal group decreased slightly.The mean number of neutrophil of the normal group decreased significantly while the mean number of lymphocyte does not change much.In the meantime,the granulocytes of the normal group decreased significantly,while lymphocytes increased significantly.The decrease of granulocytes was the main type of peripheral blood cells changes in the increased group,which does not completely comply with the common feature of viral infection.While the increase of lymphocytes is the main type of change in the normal group,and in line with the common feature of viral infection.