伴嗜酸性粒细胞增多的儿童寄生虫病与结核病的临床特点分析

目的探讨四川及周边地区伴嗜酸性粒细胞增多的寄生虫病与结核病患儿的临床特点。方法回顾性分析2012~2019年我院收治的伴外周血嗜酸性粒细胞增多的寄生虫病与结核病住院患儿的临床资料。结果共收集寄生虫病患儿146例,结核病患儿21例,两者年龄、性别及地区分布特点相似,临床表现均缺乏特异性。寄生虫病组嗜酸性粒细胞百分比高于结核病组(P<0.05);两组嗜酸性粒细胞绝对值差异无统计学意义(P>0.05)。两组患儿胸部CT结果均以斑片影、条索影、结片或结节影、肺门或纵膈淋巴结增大、胸膜增厚多见。寄生虫病组中胸腔积液和心包积液的嗜酸性粒细胞百分比中位数均为86%;结核病组中2例胸腔积液和2例腹腔积液的嗜酸性粒细胞百分比分别为3%、22%、20%及25%。结论伴嗜酸性粒细胞增多的儿童寄生虫病与结核病的临床特点相似,不易区分;但两类患儿的外周血嗜酸性粒细胞百分比有明显差异,且寄生虫病患儿浆膜腔积液以嗜酸性粒细胞增高为主,结核病患儿嗜酸性性粒细胞增高不明显,可辅助临床医师鉴别。

Analysis of clinical characteristics of parasitic diseases and tuberculosis in children with eosinophilia

Objective To explore the clinical characteristics of sick children with parasitic diseases or tuberculosis with eosinophilia in Sichuan and its surrounding areas.Methods The clinical data of hospitalized sick children with parasitic diseases or tuberculosis with peripheral blood eosinophilia in our hospital from 2012 to 2019 were retrospectively analyzed.Results A total of 146 children with parasitic diseases and 21 children with tuberculosis were collected.Their age,sex and regional distribution were similar,and their clinical manifestations were not specific.The percentage of eosinophils in the parasitic group was significantly higher than that in the tuberculosis group(P<0.05),but there was no significant difference in the absolute value of eosinophils between the two groups(P>0.05).The most common chest CT findings of the two groups were patchy shadow,stripe shadow,nodular or nodular shadow,hilar or mediastinal lymph node enlargement and pleural thickening.The median percentage of eosinophils in pleural effusion and pericardial effusion in the parasitic disease group was 86%.In the tuberculosis group,the eosinophil percentages in 2 cases of pleural effusion and 2 cases of peritoneal effusion were 3%,22%,20%and 25%,respectively.Conclusion Parasitic diseases in children with eosinophilia are similar to tuberculosis in clinical features,so it is difficult to distinguish them.However,there was a significant difference in the percentage of eosinophils in peripheral blood between the two types of diseases.Moreover,the serous effusion in children with parasitic diseases is mainly increased eosinophil while the increase of eosinophil in tuberculosis children is not obvious.This can assist clinicians to distinguish between the two types of diseases.