分析血小板（PLT）检测在儿童肺吸虫病患者临床诊断中的价值。

回顾性分析2010年1月至2017年12月十堰市人民医院感染性疾病科和儿科住院确诊的19例儿童肺吸虫病患者的临床表现、PLT计数、白细胞（WBC）、嗜酸性粒细胞计数（EOS）、胸肺部螺旋X线计算机断层摄影（MSCT）以及浆膜腔彩色多普勒超声检查结果。分析PLT变化与肺吸虫病临床表现和影像学变化间的相关性。根据PLT水平是否高于正常值分为PLT升高组（12例）和PLT正常组（7例）。

PLT升高组患者呼吸系统症状、体征异常者12例次，MSCT显示该组病例均有肺部病灶（其中9例患者伴有双侧胸腔积液、3例患者伴有单侧胸腔积液）。PLT正常组患者呼吸系统症状、体征异常者1例，MSCT显示1例患者有胸腔积液。治疗后PLT升高组患者随肺部病灶消退、PLT恢复正常；PLT正常组患者治疗前后无变化。WBC水平变化：16例患者WBC正常，3例患者WBC水平升高。WBC水平升高患者合并扁桃腺细菌感染、肠道感染、肺内感染者1例，抗菌药物治疗后WBC水平恢复正常。入组患者使用吡喹酮治疗期间未发现WBC异常。EOS变化：EOS显著升高，升高至15.9%～54.8%。驱虫疗程结束EOS比率降低至正常值上限的2倍以下，EOS疗程结束1个月后降至正常。胸部MSCT：发现肺部病灶13例次（其中PLT升高12例次、PLT正常1例次）、胸腔积液13例次（PLT升高组12例次中双侧胸腔积液9例次、单侧3例次；PLT正常组患者中单侧胸腔积液1例）；心包积液2例（两组各1例）；纵膈和腋下淋巴结肿大4例次（PLT升高组和正常组各2例次）。随着驱虫治疗显效，MSCT显示胸部病变消退。胸肺型肺吸虫病是肺吸虫病的主要类型。彩色多普勒超声浆膜腔检查：胸腔积液13例次（其中双侧9例次、单侧4例次）、心包积液2例次、腹腔积液2例次。胸肺型、腹型肺吸虫病发生胸腔和腹腔积液比较常见；随着驱虫效果显效，浆膜腔积液亦消退。

PLT水平升高对胸肺型肺吸虫病的诊断具有提示意义，结合EOS变化，对肺型肺吸虫病诊断提示意义更高。

To evaluate the clinical value of platelets detection in the diagnosis of children with paragonimiasis.

The clinical data of 19 children with paragonimiasis who were treated at Department of Infectious Diseases and Department of Pediatrics of Shiyan City Renmin Hospital from January 2010 to December 2017 were reviewed, retrospectively. The detected parameters included blood platelet count (PLT), white blood count (WBC), eosinophil count (EOS), multi-slice computed tomography (MSCT) and serous cavity color Doppler ultrasonography. The relationship between PLT changes and clinical manifestations and imaging changes of paragonimiasis were analyzed. According to whether the level of PLT was higher than the normal value, the patients were divided into two groups: increased PLT group (12 cases) and normal PLT group (7 cases).

There were 12 case times with abnormal respiratory symptoms and signs in increased PLT group, MSCT showed all patients with lung lesions in this group (among whom, 9 patients with bilateral pleural effusion and 3 patients with unilateral pleural effusion). There were 1 case with abnormal respiratory symptoms and signs in normal PLT group, MSCT showed pleural effusions in 1 patient. After treatment, the patients in increased PLT group returned to normal with the regression of pulmonary lesions; but there was no change in normal PLT group before and after treatment. The changes of WBC level: 16 patients with normal level of WBC and 3 patients with increased level of WBC. One patient with increased WBC level was complicated with tonsil bacterial infection, intestinal infection and intrapulmonary infection, but the level of WBC returned to normal after antibiotic treatment. No abnormal WBC was found in 19 cases during praziquantel treatment. The changes of EOS level: EOS increased significantly to 15.9%-54.8%. The EOS ratio decreased to less than 2 times of the normal high limit at the end of the deworming course, and decreased to normal level one month after the end of the EOS course. Chest MSCT: 13 case times with lung focus (12 case times with PLT increase, 1 case with PLT normal), 13 case times with pleural effusion (9 case times with bilateral pleural effusion and 3 case times with unilateral pleural effusion in PLT increase group; one case time with unilateral pleural effusion in PLT normal group) were found. There were 2 cases with pericardial effusion (one case in each group), 4 case times with mediastinal and axillary lymph node enlargement (2 case times in each group). With the marked effect of deworming treatment, MSCT showed that the chest lesions disappeared. Thoracopulmonary paragliasis was the main type of paragliasis. Color Doppler ultrasound showed that 13 case times with pleural effusion (including 9 case times on both sides and 4 case times on one side), 2 cases with pericardial hydrops and 2 cases with abdominal effusions. There were 13 cases of pleural effusions (bilateral 9 cases, 4 cases unilateral), 2 cases of pericardial effusion and 2 cases of abdominal effusion. Color Doppler ultrasound was performed in 13 cases of pleural effusion (including 9 cases on both sides and 4 cases on one side), 2 cases of pericardial hydrops and 2 cases of abdominal effusions. There were 13 cases of pleural effusions (bilateral 9 cases, 4 cases unilateral), 2 cases of pericardial effusion and 2 cases of abdominal effusion. Pleural and abdominal effusions were more common in chest, lung type and abdominal paragliasis, and serous effusion disappeared with the effect of deworming.

The increase of PLT level was of significance in the diagnosis of thoracic and pulmonary paragliasis. Combined with the changes of EOS, it was more beneficial to the diagnosis of pulmonary clonorchiasis.