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常见外源性诱因包括细菌、病毒等感染（脐炎、败血症、腹泻等）或药物（抗疟药、磺胺类、萘类等）所致，后者可因新生儿用药或母亲服药通过胎盘或母乳进入患儿体内引起。 | [
{
"indices": [
9,
10
],
"label": "mic",
"score": 1,
"text": "细菌"
},
{
"indices": [
12,
13
],
"label": "mic",
"score": 1,
"text": "病毒"
},
{
"indices": [
15,
16
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
18,
19
],
"label": "dis",
"score": 1,
"text": "脐炎"
},
{
"indices": [
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "败血症"
},
{
"indices": [
25,
26
],
"label": "sym",
"score": 1,
"text": "腹泻"
},
{
"indices": [
25
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
33,
34,
35
],
"label": "dru",
"score": 1,
"text": "抗疟药"
},
{
"indices": [
37,
38,
39
],
"label": "dru",
"score": 1,
"text": "磺胺类"
},
{
"indices": [
41,
42
],
"label": "dru",
"score": 1,
"text": "萘类"
},
{
"indices": [
64,
65
],
"label": "bod",
"score": 1,
"text": "胎盘"
},
{
"indices": [
67,
68
],
"label": "bod",
"score": 1,
"text": "母乳"
},
{
"indices": [
73,
74
],
"label": "bod",
"score": 1,
"text": "体内"
}
] |
部分病儿也可因注射维生素K制剂或接触樟脑丸而发生溶血。 | [
{
"indices": [
7,
8
],
"label": "pro",
"score": 1,
"text": "注射"
},
{
"indices": [
9,
10,
11,
12,
13,
14
],
"label": "dru",
"score": 1,
"text": "维生素K制剂"
},
{
"indices": [
24,
25
],
"label": "sym",
"score": 1,
"text": "溶血"
},
{
"indices": [
25
],
"label": "bod",
"score": 1,
"text": "血"
}
] |
内源性因素可能与生理性NADPH还原酶和谷胱甘肽过氧化氢酶活性较低，血糖和维生素E水平低以及缺氧、酸中毒等有关。 | [
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "生理性NADPH还原酶"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "生理性NADPH还原酶和谷胱甘肽过氧化氢酶活性较低"
},
{
"indices": [
20,
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "谷胱甘肽过氧化氢酶"
},
{
"indices": [
34,
35
],
"label": "bod",
"score": 1,
"text": "血糖"
},
{
"indices": [
34,
35,
36,
37,
38,
39,
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "血糖和维生素E水平低"
},
{
"indices": [
37,
38,
39,
40
],
"label": "bod",
"score": 1,
"text": "维生素E"
},
{
"indices": [
46,
47
],
"label": "sym",
"score": 1,
"text": "缺氧"
},
{
"indices": [
49,
50,
51
],
"label": "dis",
"score": 1,
"text": "酸中毒"
}
] |
临床上主要表现为持续轻至中度贫血和黄疸，脾脏多增大，血清胆红素不同程度的增高，网织红细胞持续增高。 | [
{
"indices": [
12,
13,
14,
15
],
"label": "dis",
"score": 1,
"text": "中度贫血"
},
{
"indices": [
17,
18
],
"label": "dis",
"score": 1,
"text": "黄疸"
},
{
"indices": [
20,
21,
22,
23,
24
],
"label": "sym",
"score": 1,
"text": "脾脏多增大"
},
{
"indices": [
20,
21
],
"label": "bod",
"score": 1,
"text": "脾脏"
},
{
"indices": [
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37
],
"label": "sym",
"score": 1,
"text": "血清胆红素不同程度的增高"
},
{
"indices": [
26,
27,
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "血清胆红素"
},
{
"indices": [
39,
40,
41,
42,
43,
44,
45,
46,
47
],
"label": "sym",
"score": 1,
"text": "网织红细胞持续增高"
},
{
"indices": [
39,
40,
41,
42,
43
],
"label": "bod",
"score": 1,
"text": "网织红细胞"
}
] |
重症者可在短期内出现溶血危象，血红蛋白可下降60%～70%，常有畏寒、发热、恶心、呕吐、腹痛和背痛等，同时出现血红蛋白尿，尿呈酱油色、浓茶色或暗红色。 | [
{
"indices": [
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "溶血危象"
},
{
"indices": [
11
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
15,
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "血红蛋白"
},
{
"indices": [
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "sym",
"score": 1,
"text": "血红蛋白可下降60%～70%"
},
{
"indices": [
32,
33
],
"label": "sym",
"score": 1,
"text": "畏寒"
},
{
"indices": [
35,
36
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
38,
39
],
"label": "sym",
"score": 1,
"text": "恶心"
},
{
"indices": [
41,
42
],
"label": "sym",
"score": 1,
"text": "呕吐"
},
{
"indices": [
44,
45
],
"label": "sym",
"score": 1,
"text": "腹痛"
},
{
"indices": [
44
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
47,
48
],
"label": "sym",
"score": 1,
"text": "背痛"
},
{
"indices": [
47
],
"label": "bod",
"score": 1,
"text": "背"
},
{
"indices": [
55,
56,
57,
58,
59
],
"label": "sym",
"score": 1,
"text": "血红蛋白尿"
},
{
"indices": [
55,
56,
57,
58
],
"label": "bod",
"score": 1,
"text": "血红蛋白"
},
{
"indices": [
59
],
"label": "bod",
"score": 1,
"text": "尿"
},
{
"indices": [
61,
62,
63,
64,
65,
66,
67,
68,
69,
70,
71,
72,
73
],
"label": "sym",
"score": 1,
"text": "尿呈酱油色、浓茶色或暗红色"
},
{
"indices": [
61
],
"label": "bod",
"score": 1,
"text": "尿"
}
] |
轻症者仅有轻度溶血，而不伴血红蛋白尿或黄疸。 | [
{
"indices": [
5,
6,
7,
8
],
"label": "sym",
"score": 1,
"text": "轻度溶血"
},
{
"indices": [
8
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
13,
14,
15,
16,
17
],
"label": "sym",
"score": 1,
"text": "血红蛋白尿"
},
{
"indices": [
13,
14,
15,
16
],
"label": "bod",
"score": 1,
"text": "血红蛋白"
},
{
"indices": [
17
],
"label": "bod",
"score": 1,
"text": "尿"
},
{
"indices": [
19,
20
],
"label": "dis",
"score": 1,
"text": "黄疸"
}
] |
药物引起的溶血性贫血临床表现与蚕豆病相似，其主要临床特点是服药1天～4天后出现血管内溶血。 | [
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "溶血性贫血"
},
{
"indices": [
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "蚕豆病"
},
{
"indices": [
39,
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "血管内溶血"
},
{
"indices": [
39,
40,
41
],
"label": "bod",
"score": 1,
"text": "血管内"
},
{
"indices": [
43
],
"label": "bod",
"score": 1,
"text": "血"
}
] |
网织红细胞增高。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "sym",
"score": 1,
"text": "网织红细胞增高"
},
{
"indices": [
0,
1,
2,
3,
4
],
"label": "ite",
"score": 1,
"text": "网织红细胞"
}
] |
此时可有发热、倦怠、巩膜黄染、腹或背痛。 | [
{
"indices": [
4,
5
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
7,
8
],
"label": "sym",
"score": 1,
"text": "倦怠"
},
{
"indices": [
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "巩膜黄染"
},
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "巩膜"
},
{
"indices": [
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "腹或背痛"
},
{
"indices": [
15
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
17
],
"label": "bod",
"score": 1,
"text": "背"
}
] |
Coombs试验阴性。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7
],
"label": "pro",
"score": 1,
"text": "Coombs试验"
}
] |
临床上按病因及病理变化的不同，分为急性单纯性胃炎、急性糜烂性胃炎、急性腐蚀性胃炎及急性化脓性胃炎，其中临床上以急性单纯性胃炎最为常见，而由于抗生素广泛应用，急性化脓性胃炎已罕见。 | [
{
"indices": [
17,
18,
19,
20,
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "急性单纯性胃炎"
},
{
"indices": [
25,
26,
27,
28,
29,
30,
31
],
"label": "dis",
"score": 1,
"text": "急性糜烂性胃炎"
},
{
"indices": [
33,
34,
35,
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "急性腐蚀性胃炎"
},
{
"indices": [
41,
42,
43,
44,
45,
46,
47
],
"label": "dis",
"score": 1,
"text": "急性化脓性胃炎"
},
{
"indices": [
55,
56,
57,
58,
59,
60,
61
],
"label": "dis",
"score": 1,
"text": "急性单纯性胃炎"
},
{
"indices": [
70,
71,
72
],
"label": "dru",
"score": 1,
"text": "抗生素"
},
{
"indices": [
78,
79,
80,
81,
82,
83,
84
],
"label": "dis",
"score": 1,
"text": "急性化脓性胃炎"
}
] |
细菌毒素以金黄色葡萄球菌为多见，偶为肉毒杆菌毒素。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "mic",
"score": 1,
"text": "细菌毒素"
},
{
"indices": [
5,
6,
7,
8,
9,
10,
11
],
"label": "mic",
"score": 1,
"text": "金黄色葡萄球菌"
},
{
"indices": [
18,
19,
20,
21,
22,
23
],
"label": "mic",
"score": 1,
"text": "肉毒杆菌毒素"
}
] |
近年发现幽门螺杆菌也是引起急性胃炎的一种病原菌。 | [
{
"indices": [
4,
5,
6,
7,
8
],
"label": "mic",
"score": 1,
"text": "幽门螺杆菌"
},
{
"indices": [
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "急性胃炎"
},
{
"indices": [
20,
21,
22
],
"label": "mic",
"score": 1,
"text": "病原菌"
}
] |
厌食、恶心、呕吐，若伴有肠炎，可有腹泻。 | [
{
"indices": [
0,
1
],
"label": "sym",
"score": 1,
"text": "厌食"
},
{
"indices": [
3,
4
],
"label": "sym",
"score": 1,
"text": "恶心"
},
{
"indices": [
6,
7
],
"label": "sym",
"score": 1,
"text": "呕吐"
},
{
"indices": [
12,
13
],
"label": "dis",
"score": 1,
"text": "肠炎"
},
{
"indices": [
17,
18
],
"label": "sym",
"score": 1,
"text": "腹泻"
},
{
"indices": [
17
],
"label": "bod",
"score": 1,
"text": "腹"
}
] |
腹泻者，粪便常规检查有少量黏液及红、白细胞。 | [
{
"indices": [
0,
1
],
"label": "sym",
"score": 1,
"text": "腹泻"
},
{
"indices": [
0
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
4,
5,
6,
7,
8,
9
],
"label": "ite",
"score": 1,
"text": "粪便常规检查"
},
{
"indices": [
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "粪便常规检查有少量黏液及红、白细胞"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "bod",
"score": 1,
"text": "红、白细胞"
}
] |
肾异位的位置包括：同侧的盆腔、髂骨、腹部、胸腔，或对侧的上述部位。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "肾异位"
},
{
"indices": [
9,
10,
11,
12,
13
],
"label": "bod",
"score": 1,
"text": "同侧的盆腔"
},
{
"indices": [
15,
16
],
"label": "bod",
"score": 1,
"text": "髂骨"
},
{
"indices": [
18,
19
],
"label": "bod",
"score": 1,
"text": "腹部"
},
{
"indices": [
21,
22
],
"label": "bod",
"score": 1,
"text": "胸腔"
},
{
"indices": [
25,
26,
27,
28,
29,
30,
31
],
"label": "bod",
"score": 1,
"text": "对侧的上述部位"
}
] |
盆腔肾与骶骨相对，位于主动脉分叉水平以下；髂位肾靠骶骨岬，位于髂窝，在髂血管的前方；腹腔肾一般位于髂嵴的上方，靠近第二腰椎。 | [
{
"indices": [
0,
1,
2
],
"label": "bod",
"score": 1,
"text": "盆腔肾"
},
{
"indices": [
4,
5
],
"label": "bod",
"score": 1,
"text": "骶骨"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19
],
"label": "bod",
"score": 1,
"text": "主动脉分叉水平以下"
},
{
"indices": [
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "髂位肾"
},
{
"indices": [
25,
26,
27
],
"label": "bod",
"score": 1,
"text": "骶骨岬"
},
{
"indices": [
31,
32
],
"label": "bod",
"score": 1,
"text": "髂窝"
},
{
"indices": [
35,
36,
37,
38,
39,
40
],
"label": "bod",
"score": 1,
"text": "髂血管的前方"
},
{
"indices": [
42,
43,
44
],
"label": "bod",
"score": 1,
"text": "腹腔肾"
},
{
"indices": [
49,
50,
51,
52,
53
],
"label": "bod",
"score": 1,
"text": "髂嵴的上方"
},
{
"indices": [
57,
58,
59,
60
],
"label": "bod",
"score": 1,
"text": "第二腰椎"
}
] |
由于肾旋转不完全，肾盂常位于肾皮质的前方，56%的异位肾可以出现集合系统积水，其中一半是由肾盂输尿管连接部梗阻或膀胱输尿管连接部狭窄引起的。 | [
{
"indices": [
2
],
"label": "bod",
"score": 1,
"text": "肾"
},
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "sym",
"score": 1,
"text": "肾旋转不完全"
},
{
"indices": [
9,
10
],
"label": "bod",
"score": 1,
"text": "肾盂"
},
{
"indices": [
14,
15,
16,
17,
18,
19
],
"label": "bod",
"score": 1,
"text": "肾皮质的前方"
},
{
"indices": [
25,
26,
27
],
"label": "dis",
"score": 1,
"text": "异位肾"
},
{
"indices": [
32,
33,
34,
35,
36,
37
],
"label": "sym",
"score": 1,
"text": "集合系统积水"
},
{
"indices": [
32,
33,
34,
35
],
"label": "bod",
"score": 1,
"text": "集合系统"
},
{
"indices": [
45,
46,
47,
48,
49,
50,
51,
52,
53,
54
],
"label": "dis",
"score": 1,
"text": "肾盂输尿管连接部梗阻"
},
{
"indices": [
56,
57,
58,
59,
60,
61,
62,
63,
64,
65
],
"label": "dis",
"score": 1,
"text": "膀胱输尿管连接部狭窄"
}
] |
异位肾的输尿管多有扭曲，但多于输尿管起始侧进入膀胱，膀胱内开口于正常的位置。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "异位肾"
},
{
"indices": [
4,
5,
6,
7,
8,
9,
10
],
"label": "sym",
"score": 1,
"text": "输尿管多有扭曲"
},
{
"indices": [
4,
5,
6
],
"label": "bod",
"score": 1,
"text": "输尿管"
},
{
"indices": [
15,
16,
17,
18,
19,
20
],
"label": "bod",
"score": 1,
"text": "输尿管起始侧"
},
{
"indices": [
23,
24
],
"label": "bod",
"score": 1,
"text": "膀胱"
},
{
"indices": [
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "膀胱内"
}
] |
男孩可出现隐睾、重复尿道及尿道下裂。 | [
{
"indices": [
5,
6
],
"label": "dis",
"score": 1,
"text": "隐睾"
},
{
"indices": [
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "重复尿道"
},
{
"indices": [
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "尿道下裂"
}
] |
绝大多数异位肾无症状；少数患儿可因肾盂或输尿管的梗阻而出现腹痛，也可有尿路感染或盆腔肿块。 | [
{
"indices": [
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "异位肾"
},
{
"indices": [
17,
18,
19,
20,
21,
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "肾盂或输尿管的梗阻"
},
{
"indices": [
17,
18
],
"label": "bod",
"score": 1,
"text": "肾盂"
},
{
"indices": [
20,
21,
22
],
"label": "bod",
"score": 1,
"text": "输尿管"
},
{
"indices": [
24,
25
],
"label": "dis",
"score": 1,
"text": "梗阻"
},
{
"indices": [
29,
30
],
"label": "sym",
"score": 1,
"text": "腹痛"
},
{
"indices": [
29
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
35,
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "尿路感染"
},
{
"indices": [
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "盆腔肿块"
},
{
"indices": [
40,
41
],
"label": "bod",
"score": 1,
"text": "盆腔"
}
] |
腹泻病是多病因、多因素引起的一组疾病，是儿童时期发病率最高的疾病之一，是世界性公共卫生问题。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "腹泻病"
}
] |
心电图表现ST段下移，T波压低、平坦、双相、倒置，出现U波，P-R间期和Q-T间期延长。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41,
42
],
"label": "sym",
"score": 1,
"text": "心电图表现ST段下移，T波压低、平坦、双相、倒置，出现U波，P-R间期和Q-T间期延长"
},
{
"indices": [
0,
1,
2
],
"label": "pro",
"score": 1,
"text": "心电图"
},
{
"indices": [
5,
6,
7
],
"label": "ite",
"score": 1,
"text": "ST段"
},
{
"indices": [
11,
12
],
"label": "ite",
"score": 1,
"text": "T波"
},
{
"indices": [
30,
31,
32,
33,
34
],
"label": "ite",
"score": 1,
"text": "P-R间期"
},
{
"indices": [
36,
37,
38,
39,
40
],
"label": "ite",
"score": 1,
"text": "Q-T间期"
}
] |
原有营养不良及佝偻病时更易出现，少数患儿可出现低镁血症，表现为手足震颤，舞蹈病样不随意运动，易受刺激，烦躁不安，严重者可发生惊厥，补充钙剂后症状无改善。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "营养不良"
},
{
"indices": [
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "佝偻病"
},
{
"indices": [
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "低镁血症"
},
{
"indices": [
31,
32,
33,
34
],
"label": "sym",
"score": 1,
"text": "手足震颤"
},
{
"indices": [
31
],
"label": "bod",
"score": 1,
"text": "手"
},
{
"indices": [
32
],
"label": "bod",
"score": 1,
"text": "足"
},
{
"indices": [
36,
37,
38,
39,
40,
41,
42,
43,
44
],
"label": "sym",
"score": 1,
"text": "舞蹈病样不随意运动"
},
{
"indices": [
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "舞蹈病"
},
{
"indices": [
46,
47,
48,
49
],
"label": "sym",
"score": 1,
"text": "易受刺激"
},
{
"indices": [
51,
52,
53,
54
],
"label": "sym",
"score": 1,
"text": "烦躁不安"
},
{
"indices": [
62,
63
],
"label": "dis",
"score": 1,
"text": "惊厥"
},
{
"indices": [
67,
68
],
"label": "dru",
"score": 1,
"text": "钙剂"
}
] |
常伴脱水和酸中毒。 | [
{
"indices": [
2,
3
],
"label": "sym",
"score": 1,
"text": "脱水"
},
{
"indices": [
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "酸中毒"
}
] |
本病为自限性疾病，病程3～8天，少数较长，大便镜检偶见少量白细胞。 | [
{
"indices": [
21,
22,
23,
24
],
"label": "pro",
"score": 1,
"text": "大便镜检"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "大便镜检偶见少量白细胞"
},
{
"indices": [
29,
30,
31
],
"label": "ite",
"score": 1,
"text": "白细胞"
}
] |
常伴有呕吐，多无发热和全身症状。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "sym",
"score": 1,
"text": "常伴有呕吐"
},
{
"indices": [
8,
9
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
11,
12
],
"label": "bod",
"score": 1,
"text": "全身"
}
] |
主要表现水、电解质紊乱。 | [
{
"indices": [
4,
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "水、电解质紊乱"
}
] |
临床症状与细菌性痢疾较难区别，需做大便培养鉴别。 | [
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "细菌性痢疾"
},
{
"indices": [
17,
18,
19,
20
],
"label": "pro",
"score": 1,
"text": "大便培养"
}
] |
伴腹痛。 | [
{
"indices": [
1,
2
],
"label": "sym",
"score": 1,
"text": "腹痛"
},
{
"indices": [
1
],
"label": "bod",
"score": 1,
"text": "腹"
}
] |
可伴发溶血尿毒综合征和血小板减少性紫癜。 | [
{
"indices": [
3,
4,
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "溶血尿毒综合征"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "血小板减少性紫癜"
}
] |
以6个月～2岁婴幼儿发病率最高，家畜、家禽是主要的感染源，经粪-口途径，动物→人或人→人传播。 | [
{
"indices": [
25,
26
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
30
],
"label": "bod",
"score": 1,
"text": "粪"
},
{
"indices": [
32
],
"label": "bod",
"score": 1,
"text": "口"
}
] |
起病急，症状与细菌性痢疾相似。 | [
{
"indices": [
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "细菌性痢疾"
}
] |
本病可并发肠系膜淋巴结炎、结节性红斑、反应性关节炎、败血症、心肌炎、急性肝炎、肝脓肿、结膜炎、脑膜炎、尿道炎或急性肾炎等。 | [
{
"indices": [
5,
6,
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "肠系膜淋巴结炎"
},
{
"indices": [
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "结节性红斑"
},
{
"indices": [
19,
20,
21,
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "反应性关节炎"
},
{
"indices": [
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "败血症"
},
{
"indices": [
30,
31,
32
],
"label": "dis",
"score": 1,
"text": "心肌炎"
},
{
"indices": [
34,
35,
36,
37
],
"label": "dis",
"score": 1,
"text": "急性肝炎"
},
{
"indices": [
39,
40,
41
],
"label": "dis",
"score": 1,
"text": "肝脓肿"
},
{
"indices": [
43,
44,
45
],
"label": "dis",
"score": 1,
"text": "结膜炎"
},
{
"indices": [
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "脑膜炎"
},
{
"indices": [
51,
52,
53
],
"label": "dis",
"score": 1,
"text": "尿道炎"
},
{
"indices": [
55,
56,
57,
58
],
"label": "dis",
"score": 1,
"text": "急性肾炎"
}
] |
多数为2岁以下婴幼儿，易在儿科病房发生流行。 | [
{
"indices": [
13,
14
],
"label": "dep",
"score": 1,
"text": "儿科"
}
] |
常伴显著的低蛋白血症，水、电解质紊乱，全身软弱呈慢性消耗状。 | [
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "低蛋白血症"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "水、电解质紊乱"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "sym",
"score": 1,
"text": "全身软弱呈慢性消耗状"
},
{
"indices": [
19,
20
],
"label": "bod",
"score": 1,
"text": "全身"
}
] |
人和动物的卡氏肺孢子虫感染率很高，但通常仅少数虫体寄生于肺泡内（隐性感染），如遇到虚弱乳幼儿、未成熟儿、先天性免疫缺陷及用免疫抑制剂治疗的白血病等免疫功能低下、尤其是T淋巴细胞功能缺陷的病儿，可引起本病。 | [
{
"indices": [
5,
6,
7,
8,
9,
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "卡氏肺孢子虫感染"
},
{
"indices": [
23,
24
],
"label": "mic",
"score": 1,
"text": "虫体"
},
{
"indices": [
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "肺泡内"
},
{
"indices": [
32,
33,
34,
35
],
"label": "dis",
"score": 1,
"text": "隐性感染"
},
{
"indices": [
41,
42,
43,
44,
45
],
"label": "sym",
"score": 1,
"text": "虚弱乳幼儿"
},
{
"indices": [
47,
48,
49,
50
],
"label": "sym",
"score": 1,
"text": "未成熟儿"
},
{
"indices": [
52,
53,
54,
55,
56,
57,
58
],
"label": "sym",
"score": 1,
"text": "先天性免疫缺陷"
},
{
"indices": [
61,
62,
63,
64,
65,
66,
67
],
"label": "pro",
"score": 1,
"text": "免疫抑制剂治疗"
},
{
"indices": [
69,
70,
71
],
"label": "dis",
"score": 1,
"text": "白血病"
},
{
"indices": [
73,
74,
75,
76,
77,
78
],
"label": "sym",
"score": 1,
"text": "免疫功能低下"
},
{
"indices": [
83,
84,
85,
86,
87,
88,
89,
90,
91
],
"label": "sym",
"score": 1,
"text": "T淋巴细胞功能缺陷"
},
{
"indices": [
83,
84,
85,
86,
87
],
"label": "bod",
"score": 1,
"text": "T淋巴细胞"
}
] |
临床表现可分为两个类型：①婴儿型：主要发生于1～4个月虚弱婴儿及未成熟儿，起病缓慢，全身症状突出，主要表现为吃奶不好、烦躁不安，早期出现呼吸加快和发绀，1～2周内逐渐加重，出现咳嗽、鼻扇及三凹征，但肺部几乎听不到啰音。 | [
{
"indices": [
42,
43
],
"label": "bod",
"score": 1,
"text": "全身"
},
{
"indices": [
54,
55,
56,
57
],
"label": "sym",
"score": 1,
"text": "吃奶不好"
},
{
"indices": [
59,
60,
61,
62
],
"label": "sym",
"score": 1,
"text": "烦躁不安"
},
{
"indices": [
68,
69,
70,
71
],
"label": "sym",
"score": 1,
"text": "呼吸加快"
},
{
"indices": [
73,
74
],
"label": "sym",
"score": 1,
"text": "发绀"
},
{
"indices": [
88,
89
],
"label": "sym",
"score": 1,
"text": "咳嗽"
},
{
"indices": [
91,
92
],
"label": "sym",
"score": 1,
"text": "鼻扇"
},
{
"indices": [
91
],
"label": "bod",
"score": 1,
"text": "鼻"
},
{
"indices": [
94,
95,
96
],
"label": "sym",
"score": 1,
"text": "三凹征"
},
{
"indices": [
99,
100
],
"label": "bod",
"score": 1,
"text": "肺部"
},
{
"indices": [
106,
107
],
"label": "sym",
"score": 1,
"text": "啰音"
}
] |
②儿童型：主要发生于获得性免疫功能低下和应用大量免疫抑制剂者。 | [
{
"indices": [
10,
11,
12,
13,
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "获得性免疫功能低下"
},
{
"indices": [
24,
25,
26,
27,
28
],
"label": "dru",
"score": 1,
"text": "免疫抑制剂"
}
] |
起病急骤，常见症状为发热、咳嗽、呼吸加快、发绀、鼻扇及腹泻等，但肺部亦多无啰音。 | [
{
"indices": [
10,
11
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
13,
14
],
"label": "sym",
"score": 1,
"text": "咳嗽"
},
{
"indices": [
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "呼吸加快"
},
{
"indices": [
21,
22
],
"label": "sym",
"score": 1,
"text": "发绀"
},
{
"indices": [
24,
25
],
"label": "sym",
"score": 1,
"text": "鼻扇"
},
{
"indices": [
24
],
"label": "bod",
"score": 1,
"text": "鼻"
},
{
"indices": [
27,
28
],
"label": "sym",
"score": 1,
"text": "腹泻"
},
{
"indices": [
27
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
32,
33
],
"label": "bod",
"score": 1,
"text": "肺部"
},
{
"indices": [
37,
38
],
"label": "sym",
"score": 1,
"text": "啰音"
}
] |
次日肺内迅速出现广泛融合小片影、肺透亮度减低，可见支气管充气征、泡性肺气肿、病变密度不均匀，肺门影不大。 | [
{
"indices": [
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14
],
"label": "sym",
"score": 1,
"text": "肺内迅速出现广泛融合小片影"
},
{
"indices": [
2,
3
],
"label": "bod",
"score": 1,
"text": "肺内"
},
{
"indices": [
16,
17,
18,
19
],
"label": "ite",
"score": 1,
"text": "肺透亮度"
},
{
"indices": [
16,
17,
18,
19,
20,
21
],
"label": "sym",
"score": 1,
"text": "肺透亮度减低"
},
{
"indices": [
25,
26,
27,
28,
29,
30
],
"label": "sym",
"score": 1,
"text": "支气管充气征"
},
{
"indices": [
25,
26,
27
],
"label": "bod",
"score": 1,
"text": "支气管"
},
{
"indices": [
32,
33,
34,
35,
36
],
"label": "dis",
"score": 1,
"text": "泡性肺气肿"
},
{
"indices": [
38,
39,
40,
41,
42,
43,
44
],
"label": "sym",
"score": 1,
"text": "病变密度不均匀"
},
{
"indices": [
46,
47,
48
],
"label": "ite",
"score": 1,
"text": "肺门影"
}
] |
在早产婴儿、新生儿和先天或后天性免疫缺陷或抑制的患儿，如出现重度呼吸困难而肺部体征极少，X线胸片出现上述改变时，应考虑为本病。 | [
{
"indices": [
1,
2
],
"label": "dis",
"score": 1,
"text": "早产"
},
{
"indices": [
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "先天或后天性免疫缺陷或抑制"
},
{
"indices": [
30,
31,
32,
33,
34,
35
],
"label": "sym",
"score": 1,
"text": "重度呼吸困难"
},
{
"indices": [
37,
38
],
"label": "bod",
"score": 1,
"text": "肺部"
},
{
"indices": [
44,
45,
46,
47
],
"label": "pro",
"score": 1,
"text": "X线胸片"
}
] |
亦可用PCR法检测痰及气道分泌物中卡氏肺孢子虫的DNA。 | [
{
"indices": [
3,
4,
5,
6,
7,
8
],
"label": "pro",
"score": 1,
"text": "PCR法检测"
},
{
"indices": [
9
],
"label": "bod",
"score": 1,
"text": "痰"
},
{
"indices": [
11,
12,
13,
14,
15
],
"label": "bod",
"score": 1,
"text": "气道分泌物"
},
{
"indices": [
17,
18,
19,
20,
21,
22,
23,
24,
25,
26
],
"label": "ite",
"score": 1,
"text": "卡氏肺孢子虫的DNA"
}
] |
缺铁不仅会引起小细胞低色素性的贫血，不利于儿童正常的行为和生长发育，影响胃肠道的消化吸收功能和机体免疫功能，还易导致铅元素的吸收增加。 | [
{
"indices": [
0,
1
],
"label": "sym",
"score": 1,
"text": "缺铁"
},
{
"indices": [
1
],
"label": "bod",
"score": 1,
"text": "铁"
},
{
"indices": [
7,
8,
9,
10,
11,
12,
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "小细胞低色素性的贫血"
},
{
"indices": [
34,
35,
36,
37,
38,
39,
40,
41,
42,
43,
44,
45,
46,
47,
48,
49,
50,
51,
52
],
"label": "sym",
"score": 1,
"text": "影响胃肠道的消化吸收功能和机体免疫功能"
},
{
"indices": [
36,
37,
38
],
"label": "bod",
"score": 1,
"text": "胃肠道"
},
{
"indices": [
47,
48
],
"label": "bod",
"score": 1,
"text": "机体"
},
{
"indices": [
58,
59,
60,
61,
62,
63,
64,
65
],
"label": "sym",
"score": 1,
"text": "铅元素的吸收增加"
}
] |
缺锌表现为生长发育落后，性发育障碍，情绪冷漠，厌食、味觉异常和异食癖，皮肤易感染，伤口愈合延迟，母孕期如缺乏锌会引起胎儿畸形等。 | [
{
"indices": [
0,
1
],
"label": "sym",
"score": 1,
"text": "缺锌"
},
{
"indices": [
5,
6,
7,
8,
9,
10
],
"label": "sym",
"score": 1,
"text": "生长发育落后"
},
{
"indices": [
12,
13,
14,
15,
16
],
"label": "sym",
"score": 1,
"text": "性发育障碍"
},
{
"indices": [
18,
19,
20,
21
],
"label": "sym",
"score": 1,
"text": "情绪冷漠"
},
{
"indices": [
23,
24
],
"label": "sym",
"score": 1,
"text": "厌食"
},
{
"indices": [
26,
27,
28,
29
],
"label": "sym",
"score": 1,
"text": "味觉异常"
},
{
"indices": [
31,
32,
33
],
"label": "sym",
"score": 1,
"text": "异食癖"
},
{
"indices": [
35,
36,
37,
38,
39
],
"label": "sym",
"score": 1,
"text": "皮肤易感染"
},
{
"indices": [
35,
36
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
38,
39
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
41,
42,
43,
44,
45,
46
],
"label": "sym",
"score": 1,
"text": "伤口愈合延迟"
},
{
"indices": [
41,
42
],
"label": "dis",
"score": 1,
"text": "伤口"
},
{
"indices": [
52,
53,
54
],
"label": "sym",
"score": 1,
"text": "缺乏锌"
},
{
"indices": [
54
],
"label": "bod",
"score": 1,
"text": "锌"
},
{
"indices": [
58,
59,
60,
61
],
"label": "dis",
"score": 1,
"text": "胎儿畸形"
}
] |
铬缺乏时会引起生长发育迟缓，糖耐量下降和血脂增高等。 | [
{
"indices": [
0,
1,
2
],
"label": "sym",
"score": 1,
"text": "铬缺乏"
},
{
"indices": [
0
],
"label": "bod",
"score": 1,
"text": "铬"
},
{
"indices": [
7,
8,
9,
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "生长发育迟缓"
},
{
"indices": [
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "糖耐量下降"
},
{
"indices": [
14,
15,
16
],
"label": "ite",
"score": 1,
"text": "糖耐量"
},
{
"indices": [
20,
21,
22,
23
],
"label": "sym",
"score": 1,
"text": "血脂增高"
},
{
"indices": [
20,
21
],
"label": "bod",
"score": 1,
"text": "血脂"
}
] |
根据Wood临床评分标准可以对哮喘的病情做出判断（表8-8）。 | [
{
"indices": [
15,
16
],
"label": "dis",
"score": 1,
"text": "哮喘"
}
] |
硫酸镁通过抑制钙离子介导的平滑肌收缩，扩张支气管；可用于6岁以上，对其他平喘治疗无效患儿。 | [
{
"indices": [
0,
1,
2
],
"label": "dru",
"score": 1,
"text": "硫酸镁"
},
{
"indices": [
13,
14,
15
],
"label": "bod",
"score": 1,
"text": "平滑肌"
},
{
"indices": [
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "支气管"
},
{
"indices": [
36,
37,
38,
39
],
"label": "pro",
"score": 1,
"text": "平喘治疗"
}
] |
病情缓解后全身用糖皮质激素应逐渐减量，可继续吸入普米克令舒。 | [
{
"indices": [
8,
9,
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "糖皮质激素"
},
{
"indices": [
24,
25,
26,
27,
28
],
"label": "dru",
"score": 1,
"text": "普米克令舒"
}
] |
体格检查可见咽侧壁膨出。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10
],
"label": "sym",
"score": 1,
"text": "体格检查可见咽侧壁膨出"
},
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "体格检查"
},
{
"indices": [
6,
7,
8
],
"label": "bod",
"score": 1,
"text": "咽侧壁"
}
] |
急性Q热起病似流感样症状，可有间质性肺炎或肉芽肿肝炎表现。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "急性Q热"
},
{
"indices": [
6,
7,
8,
9,
10,
11
],
"label": "sym",
"score": 1,
"text": "似流感样症状"
},
{
"indices": [
7,
8
],
"label": "dis",
"score": 1,
"text": "流感"
},
{
"indices": [
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "间质性肺炎"
},
{
"indices": [
21,
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "肉芽肿肝炎"
}
] |
慢性Q热表现为心内膜炎，但血培养阴性。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "慢性Q热"
},
{
"indices": [
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "心内膜炎"
},
{
"indices": [
13,
14,
15
],
"label": "pro",
"score": 1,
"text": "血培养"
}
] |
约2/3患者伴有肺部病变，症状轻重不等。 | [
{
"indices": [
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "肺部病变"
}
] |
肺部有时无体征，或呼吸音减低，可听到细小水泡音。 | [
{
"indices": [
0,
1
],
"label": "bod",
"score": 1,
"text": "肺部"
},
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "sym",
"score": 1,
"text": "肺部有时无体征"
},
{
"indices": [
9,
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "呼吸音减低"
},
{
"indices": [
18,
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "细小水泡音"
}
] |
少数病例肝脾肿大，并发心肌炎、脑炎或脑膜炎。 | [
{
"indices": [
4,
5
],
"label": "bod",
"score": 1,
"text": "肝脾"
},
{
"indices": [
4,
5,
6,
7
],
"label": "sym",
"score": 1,
"text": "肝脾肿大"
},
{
"indices": [
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "心肌炎"
},
{
"indices": [
15,
16
],
"label": "dis",
"score": 1,
"text": "脑炎"
},
{
"indices": [
18,
19,
20
],
"label": "dis",
"score": 1,
"text": "脑膜炎"
}
] |
急性Q热数月或数年后可能出现瓣膜损害的心内膜炎。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "急性Q热"
},
{
"indices": [
14,
15,
16,
17,
18,
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "瓣膜损害的心内膜炎"
},
{
"indices": [
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "瓣膜损害"
},
{
"indices": [
19,
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "心内膜炎"
}
] |
慢性Q热的其他表现还有血管受累、动脉瘤、骨髓炎、长期发热、肺炎、肝炎或紫癜样皮疹。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "慢性Q热"
},
{
"indices": [
11,
12
],
"label": "bod",
"score": 1,
"text": "血管"
},
{
"indices": [
11,
12,
13,
14
],
"label": "sym",
"score": 1,
"text": "血管受累"
},
{
"indices": [
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "动脉瘤"
},
{
"indices": [
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "骨髓炎"
},
{
"indices": [
24,
25,
26,
27
],
"label": "sym",
"score": 1,
"text": "长期发热"
},
{
"indices": [
29,
30
],
"label": "dis",
"score": 1,
"text": "肺炎"
},
{
"indices": [
32,
33
],
"label": "dis",
"score": 1,
"text": "肝炎"
},
{
"indices": [
35,
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "紫癜样皮疹"
}
] |
经典的病理分类将NB分成3型，即神经母细胞瘤、神经节母细胞瘤、神经节细胞瘤，这三个类型反映了NB的分化、成熟过程。 | [
{
"indices": [
8,
9
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "神经母细胞瘤"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29
],
"label": "dis",
"score": 1,
"text": "神经节母细胞瘤"
},
{
"indices": [
31,
32,
33,
34,
35,
36
],
"label": "dis",
"score": 1,
"text": "神经节细胞瘤"
},
{
"indices": [
46,
47
],
"label": "dis",
"score": 1,
"text": "NB"
}
] |
65%患儿肿瘤原发于腹腔，大年龄儿童中肾上腺原发占40%，而在婴儿中只占25%。 | [
{
"indices": [
5,
6
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
10,
11
],
"label": "bod",
"score": 1,
"text": "腹腔"
},
{
"indices": [
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "肾上腺"
}
] |
最常见的症状为不同部位的肿块。 | [
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "不同部位的肿块"
}
] |
NB主要转移途径为淋巴及血行。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
9,
10
],
"label": "bod",
"score": 1,
"text": "淋巴"
},
{
"indices": [
12
],
"label": "bod",
"score": 1,
"text": "血"
}
] |
在局限性病变病人中约35%有局部淋巴结浸润，血行转移主要发生于骨髓、骨、肝和皮肤，终末期或复发时可有脑和肺转移，但较少见。 | [
{
"indices": [
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "局限性病变"
},
{
"indices": [
14,
15,
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "局部淋巴结浸润"
},
{
"indices": [
14,
15,
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "局部淋巴结"
},
{
"indices": [
22
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
31,
32
],
"label": "bod",
"score": 1,
"text": "骨髓"
},
{
"indices": [
34
],
"label": "bod",
"score": 1,
"text": "骨"
},
{
"indices": [
36
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
38,
39
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
45,
46,
47,
48,
49,
50,
51,
52,
53,
54
],
"label": "sym",
"score": 1,
"text": "复发时可有脑和肺转移"
},
{
"indices": [
50
],
"label": "bod",
"score": 1,
"text": "脑"
},
{
"indices": [
52
],
"label": "bod",
"score": 1,
"text": "肺"
}
] |
婴儿病例就诊时局限性病变、局限性病变伴有局部淋巴结转移、播散性病变分别为39%、18%和25%；但在大年龄儿童中分别为19%、13%和68%，也即大年龄患儿就诊时多数已处疾病晚期。 | [
{
"indices": [
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "局限性病变"
},
{
"indices": [
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "局限性病变"
},
{
"indices": [
20,
21,
22,
23,
24,
25,
26
],
"label": "sym",
"score": 1,
"text": "局部淋巴结转移"
},
{
"indices": [
20,
21,
22,
23,
24
],
"label": "bod",
"score": 1,
"text": "局部淋巴结"
},
{
"indices": [
28,
29,
30,
31,
32
],
"label": "dis",
"score": 1,
"text": "播散性病变"
}
] |
为确定病变范围及临床分期，应作骨髓活检或涂片，选择性骨骼平片、胸片、骨扫描，胸、腹部CT或MRI。 | [
{
"indices": [
15,
16,
17,
18,
19,
20,
21
],
"label": "pro",
"score": 1,
"text": "骨髓活检或涂片"
},
{
"indices": [
26,
27,
28,
29
],
"label": "pro",
"score": 1,
"text": "骨骼平片"
},
{
"indices": [
31,
32
],
"label": "pro",
"score": 1,
"text": "胸片"
},
{
"indices": [
34,
35,
36
],
"label": "pro",
"score": 1,
"text": "骨扫描"
},
{
"indices": [
38,
39,
40,
41,
42,
43,
44,
45,
46,
47
],
"label": "pro",
"score": 1,
"text": "胸、腹部CT或MRI"
}
] |
影像学所示肿块中常有钙化灶，原发于胸腔时多见于后纵隔脊柱两侧，原发于腹腔时多见于肾上腺或后腹膜脊柱两侧。 | [
{
"indices": [
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "钙化灶"
},
{
"indices": [
17,
18
],
"label": "bod",
"score": 1,
"text": "胸腔"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29
],
"label": "bod",
"score": 1,
"text": "后纵隔脊柱两侧"
},
{
"indices": [
34,
35
],
"label": "bod",
"score": 1,
"text": "腹腔"
},
{
"indices": [
40,
41,
42
],
"label": "bod",
"score": 1,
"text": "肾上腺"
},
{
"indices": [
44,
45,
46,
47,
48,
49,
50
],
"label": "bod",
"score": 1,
"text": "后腹膜脊柱两侧"
}
] |
NB时血LDH可升高，并与肿瘤负荷成正比。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
3,
4,
5,
6
],
"label": "ite",
"score": 1,
"text": "血LDH"
},
{
"indices": [
13,
14,
15,
16
],
"label": "ite",
"score": 1,
"text": "肿瘤负荷"
}
] |
可用荧光原位杂交法（FISH）检测肿瘤细胞N-MYC的扩增情况，如大于10倍，常提示预后不良。 | [
{
"indices": [
2,
3,
4,
5,
6,
7,
8
],
"label": "pro",
"score": 1,
"text": "荧光原位杂交法"
},
{
"indices": [
10,
11,
12,
13
],
"label": "pro",
"score": 1,
"text": "FISH"
},
{
"indices": [
17,
18,
19,
20,
21,
22,
23,
24,
25
],
"label": "bod",
"score": 1,
"text": "肿瘤细胞N-MYC"
}
] |
Ⅰ期：肿瘤局限于原发器官。 | [
{
"indices": [
3,
4
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
Ⅱ期：肿瘤超出原发器官，但未超过中线，同侧淋巴结可能受累。 | [
{
"indices": [
3,
4
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
19,
20,
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "同侧淋巴结"
}
] |
Ⅲ期：肿瘤超过中线，双侧淋巴结可能受累。 | [
{
"indices": [
3,
4
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
10,
11,
12,
13,
14
],
"label": "bod",
"score": 1,
"text": "双侧淋巴结"
}
] |
Ⅵs期：＜1岁，原发灶为Ⅰ、Ⅱ期，但又局限于肝、皮肤、骨髓的转移灶。 | [
{
"indices": [
22
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
24,
25
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
27,
28
],
"label": "bod",
"score": 1,
"text": "骨髓"
}
] |
美国CCSG协作组报告晚期NB在接受自身骨髓移植后4年无进展性疾病生存率为38%，各项处理方案结果未显示有差别。 | [
{
"indices": [
13,
14
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
20,
21,
22,
23
],
"label": "pro",
"score": 1,
"text": "骨髓移植"
}
] |
对Ⅳ期具有其他预后不良因素者（如N-myc扩增，年龄＞2岁，诱导治疗未获缓解者），自身骨髓移植组预后要比常规治疗好。 | [
{
"indices": [
16,
17,
18,
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "N-myc扩增"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "bod",
"score": 1,
"text": "N-myc"
},
{
"indices": [
43,
44,
45,
46
],
"label": "pro",
"score": 1,
"text": "骨髓移植"
}
] |
NB对放疗敏感，但全身放疗在干细胞移植预处理方案中的应用尚有争论。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
3,
4
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
11,
12
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
14,
15,
16,
17,
18
],
"label": "pro",
"score": 1,
"text": "干细胞移植"
}
] |
NB的原发部位复发机会较高，因此对Ⅲ、Ⅳ期病人仍有主张化疗同时采用局部放疗，但其有效性不明确。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "NB"
},
{
"indices": [
33,
34,
35,
36
],
"label": "pro",
"score": 1,
"text": "局部放疗"
}
] |
包囊携带者和慢性患者为主要传染源，通过粪-口传播。 | [
{
"indices": [
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "粪-口"
}
] |
少数表现似细菌性痢疾，发热，腹痛，体温达39℃，大便带血，每日10次以上，数天后急性症状缓解，10～20天后自行痊愈，也可转为慢性病变。 | [
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "细菌性痢疾"
},
{
"indices": [
11,
12
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
14,
15
],
"label": "sym",
"score": 1,
"text": "腹痛"
},
{
"indices": [
14
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
17,
18,
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "体温达39℃"
},
{
"indices": [
17,
18
],
"label": "ite",
"score": 1,
"text": "体温"
},
{
"indices": [
24,
25
],
"label": "bod",
"score": 1,
"text": "大便"
},
{
"indices": [
24,
25,
26,
27
],
"label": "sym",
"score": 1,
"text": "大便带血"
},
{
"indices": [
27
],
"label": "bod",
"score": 1,
"text": "血"
}
] |
虽然无菌性脑膜炎也可由其他病原体感染或某些非感染性疾病引起，但多数病例系病毒所致。 | [
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "无菌性脑膜炎"
},
{
"indices": [
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "病原体感染"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "某些非感染性疾病"
},
{
"indices": [
36,
37
],
"label": "mic",
"score": 1,
"text": "病毒"
}
] |
其中肠道病毒最为常见，HSV-2次之，其他如腺病毒、VZV、CMV、EBV、风疹病毒、麻疹病毒以及轮状病毒等也均有报道。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "mic",
"score": 1,
"text": "肠道病毒"
},
{
"indices": [
11,
12,
13,
14,
15
],
"label": "mic",
"score": 1,
"text": "HSV-2"
},
{
"indices": [
22,
23,
24
],
"label": "mic",
"score": 1,
"text": "腺病毒"
},
{
"indices": [
26,
27,
28
],
"label": "mic",
"score": 1,
"text": "VZV"
},
{
"indices": [
30,
31,
32
],
"label": "mic",
"score": 1,
"text": "CMV"
},
{
"indices": [
34,
35,
36
],
"label": "mic",
"score": 1,
"text": "EBV"
},
{
"indices": [
38,
39,
40,
41
],
"label": "mic",
"score": 1,
"text": "风疹病毒"
},
{
"indices": [
43,
44,
45,
46
],
"label": "mic",
"score": 1,
"text": "麻疹病毒"
},
{
"indices": [
49,
50,
51,
52
],
"label": "mic",
"score": 1,
"text": "轮状病毒"
}
] |
主要临床表现包括发热、头痛、呕吐和颈项强直。 | [
{
"indices": [
8,
9
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
11,
12
],
"label": "sym",
"score": 1,
"text": "头痛"
},
{
"indices": [
11
],
"label": "bod",
"score": 1,
"text": "头"
},
{
"indices": [
14,
15
],
"label": "sym",
"score": 1,
"text": "呕吐"
},
{
"indices": [
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "颈项强直"
},
{
"indices": [
17,
18
],
"label": "bod",
"score": 1,
"text": "颈项"
}
] |
部分病例可伴发轻微脑实质受累而出现不同程度的意识障碍，如易激惹、嗜睡或昏睡等。 | [
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "轻微脑实质受累"
},
{
"indices": [
9,
10,
11
],
"label": "bod",
"score": 1,
"text": "脑实质"
},
{
"indices": [
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "意识障碍"
},
{
"indices": [
28,
29,
30
],
"label": "sym",
"score": 1,
"text": "易激惹"
},
{
"indices": [
32,
33
],
"label": "sym",
"score": 1,
"text": "嗜睡"
},
{
"indices": [
35,
36
],
"label": "sym",
"score": 1,
"text": "昏睡"
}
] |
早期可出现惊厥发作。 | [
{
"indices": [
5,
6,
7,
8
],
"label": "sym",
"score": 1,
"text": "惊厥发作"
},
{
"indices": [
5,
6
],
"label": "dis",
"score": 1,
"text": "惊厥"
}
] |
例如，腮腺炎病毒脑膜炎常伴发唾液腺肿痛；肠道病毒感染可伴有皮疹；如病情较重，伴淋巴结肿大或轻度肝区触痛及皮疹，应注意EB病毒感染。 | [
{
"indices": [
3,
4,
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "腮腺炎病毒脑膜炎"
},
{
"indices": [
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "唾液腺肿痛"
},
{
"indices": [
14,
15,
16
],
"label": "bod",
"score": 1,
"text": "唾液腺"
},
{
"indices": [
20,
21,
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "肠道病毒感染"
},
{
"indices": [
29,
30
],
"label": "sym",
"score": 1,
"text": "皮疹"
},
{
"indices": [
29
],
"label": "bod",
"score": 1,
"text": "皮"
},
{
"indices": [
38,
39,
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "伴淋巴结肿大"
},
{
"indices": [
39,
40,
41
],
"label": "bod",
"score": 1,
"text": "淋巴结"
},
{
"indices": [
45,
46,
47,
48,
49,
50
],
"label": "sym",
"score": 1,
"text": "轻度肝区触痛"
},
{
"indices": [
47
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
52,
53
],
"label": "sym",
"score": 1,
"text": "皮疹"
},
{
"indices": [
58,
59,
60,
61,
62,
63
],
"label": "dis",
"score": 1,
"text": "EB病毒感染"
}
] |
Mollaret脑膜炎的主要表现是反复发作性的发热、头痛、疲劳及脑膜刺激征。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "Mollaret脑膜炎"
},
{
"indices": [
23,
24
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
26,
27
],
"label": "sym",
"score": 1,
"text": "头痛"
},
{
"indices": [
26
],
"label": "bod",
"score": 1,
"text": "头"
},
{
"indices": [
29,
30
],
"label": "sym",
"score": 1,
"text": "疲劳"
},
{
"indices": [
32,
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "脑膜刺激征"
},
{
"indices": [
32,
33
],
"label": "bod",
"score": 1,
"text": "脑膜"
}
] |
在疾病极期可有轻度颅压增高。 | [
{
"indices": [
7,
8,
9,
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "轻度颅压增高"
}
] |
脑电图检查常见弥漫性慢波增多，个别可见痫样放电，随病情好转脑电图异常也逐渐恢复，在并发癫痫的病例仍可见到痫样放电。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "pro",
"score": 1,
"text": "脑电图检查"
},
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "弥漫性慢波增多"
},
{
"indices": [
19,
20,
21,
22
],
"label": "sym",
"score": 1,
"text": "痫样放电"
},
{
"indices": [
29,
30,
31
],
"label": "pro",
"score": 1,
"text": "脑电图"
},
{
"indices": [
41,
42,
43,
44
],
"label": "dis",
"score": 1,
"text": "并发癫痫"
},
{
"indices": [
52,
53,
54,
55
],
"label": "sym",
"score": 1,
"text": "痫样放电"
}
] |
病毒分离和血清学试验是明确病因的基本方法。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "病毒分离"
},
{
"indices": [
5,
6,
7,
8,
9
],
"label": "pro",
"score": 1,
"text": "血清学试验"
}
] |
血清学试验一般采用双份血清法，分别于发病早期及恢复期取血或脑脊液送检，抗体滴度如有4倍以上升高则可确诊。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "pro",
"score": 1,
"text": "血清学试验"
},
{
"indices": [
11,
12
],
"label": "bod",
"score": 1,
"text": "血清"
},
{
"indices": [
27
],
"label": "bod",
"score": 1,
"text": "血"
},
{
"indices": [
29,
30,
31
],
"label": "bod",
"score": 1,
"text": "脑脊液"
}
] |
包括：①维持水电解质平衡和适当的营养；②控制高热；③镇静剂与止惊剂的应用，适用于出现过度兴奋、多动或惊厥者；④病情监护，如出现昏迷或更严重的神经症状体征，则应按病毒性脑炎治疗。 | [
{
"indices": [
6,
7,
8,
9
],
"label": "ite",
"score": 1,
"text": "水电解质"
},
{
"indices": [
26,
27,
28
],
"label": "dru",
"score": 1,
"text": "镇静剂"
},
{
"indices": [
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "止惊剂"
},
{
"indices": [
42,
43,
44,
45
],
"label": "sym",
"score": 1,
"text": "过度兴奋"
},
{
"indices": [
47,
48
],
"label": "sym",
"score": 1,
"text": "多动"
},
{
"indices": [
50,
51
],
"label": "dis",
"score": 1,
"text": "惊厥"
},
{
"indices": [
63,
64
],
"label": "sym",
"score": 1,
"text": "昏迷"
},
{
"indices": [
66,
67,
68,
69,
70,
71,
72,
73,
74,
75
],
"label": "sym",
"score": 1,
"text": "更严重的神经症状体征"
},
{
"indices": [
80,
81,
82,
83,
84
],
"label": "dis",
"score": 1,
"text": "病毒性脑炎"
}
] |
确诊或高度怀疑疱疹病毒或其他DNA病毒感染者，应尽早给予无环鸟苷治疗；每次剂量为5～10mg/kg，于1小时内静脉注射，每8小时1次，疗程1～2周。 | [
{
"indices": [
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "疱疹病毒"
},
{
"indices": [
12,
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "dis",
"score": 1,
"text": "其他DNA病毒感染"
},
{
"indices": [
28,
29,
30,
31
],
"label": "dru",
"score": 1,
"text": "无环鸟苷"
}
] |
Cater及Evans的研究认为，只要父母一方有过NTDs病史，则其后代NTDs的发病率为3%，明显高于一般人群。 | [
{
"indices": [
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "NTDs"
},
{
"indices": [
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "NTDs"
}
] |
因而NTDs的发生是多基因遗传所致，至于遗传因素对于NTDs发生有多大作用，则尚未定论。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "NTDs"
},
{
"indices": [
26,
27,
28,
29
],
"label": "dis",
"score": 1,
"text": "NTDs"
}
] |
与NTDs有关联的常见环境因素包括母亲孕早期叶酸和其他多种维生素缺乏，锌和其他微量元素缺乏，严重妊娠反应，病毒感染，服用某些药物，吸烟，酗酒，电离辐射，以及接触某些化学物质等。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "NTDs"
},
{
"indices": [
35,
36,
37,
38,
39,
40,
41,
42,
43,
44
],
"label": "sym",
"score": 1,
"text": "锌和其他微量元素缺乏"
},
{
"indices": [
46,
47,
48,
49,
50,
51
],
"label": "sym",
"score": 1,
"text": "严重妊娠反应"
},
{
"indices": [
53,
54,
55,
56
],
"label": "dis",
"score": 1,
"text": "病毒感染"
}
] |
母亲孕早期锌缺乏也是引起胎儿发生NTDs的一种环境因素。 | [
{
"indices": [
5,
6,
7
],
"label": "sym",
"score": 1,
"text": "锌缺乏"
},
{
"indices": [
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "NTDs"
}
] |
至于严重妊娠反应诱发NTDs的原因，可能是因为严重呕吐使水分丢失引起一时性脱水，造成微量元素（如锌）或维生素（如叶酸）缺乏所致。 | [
{
"indices": [
4,
5,
6,
7
],
"label": "sym",
"score": 1,
"text": "妊娠反应"
},
{
"indices": [
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "NTDs"
},
{
"indices": [
23,
24,
25,
26
],
"label": "sym",
"score": 1,
"text": "严重呕吐"
},
{
"indices": [
34,
35,
36,
37,
38
],
"label": "sym",
"score": 1,
"text": "一时性脱水"
}
] |
妊娠早期弓形体感染也可能导致NTDs。 | [
{
"indices": [
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "弓形体感染"
},
{
"indices": [
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "NTDs"
}
] |
可伴有身体其他部位畸形，如腭裂、颈部脊柱裂、胸腔狭小、上下肢比例失调、胫骨和指缺如等。 | [
{
"indices": [
13,
14
],
"label": "dis",
"score": 1,
"text": "腭裂"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "dis",
"score": 1,
"text": "颈部脊柱裂"
},
{
"indices": [
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "胸腔狭小"
},
{
"indices": [
22,
23
],
"label": "bod",
"score": 1,
"text": "胸腔"
},
{
"indices": [
27,
28,
29,
30,
31,
32,
33
],
"label": "sym",
"score": 1,
"text": "上下肢比例失调"
},
{
"indices": [
27,
28,
29
],
"label": "bod",
"score": 1,
"text": "上下肢"
},
{
"indices": [
35,
36,
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "胫骨和指缺如"
}
] |
②神经系统症状：轻者无明显神经系统症状，重者与发生的部位及受损的程度有关，可表现智力低下、抽搐和不同程度的上运动神经元瘫痪等。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "bod",
"score": 1,
"text": "神经系统"
},
{
"indices": [
1,
2,
3,
4,
5,
6
],
"label": "sym",
"score": 1,
"text": "神经系统症状"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "明显神经系统症状"
},
{
"indices": [
13,
14,
15,
16
],
"label": "bod",
"score": 1,
"text": "神经系统"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29,
30
],
"label": "sym",
"score": 1,
"text": "发生的部位及受损"
},
{
"indices": [
23,
24,
25,
26,
27
],
"label": "bod",
"score": 1,
"text": "发生的部位"
},
{
"indices": [
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "智力低下"
},
{
"indices": [
45,
46
],
"label": "sym",
"score": 1,
"text": "抽搐"
},
{
"indices": [
53,
54,
55,
56,
57,
58,
59,
60
],
"label": "dis",
"score": 1,
"text": "上运动神经元瘫痪"
}
] |
部分患儿成年后有慢性腰痛。 | [
{
"indices": [
8,
9,
10,
11
],
"label": "sym",
"score": 1,
"text": "慢性腰痛"
},
{
"indices": [
10
],
"label": "bod",
"score": 1,
"text": "腰"
}
] |
脊髓脊膜膨出可有不同程度的双下肢瘫痪及大小便失禁等。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "sym",
"score": 1,
"text": "脊髓脊膜膨出"
},
{
"indices": [
0,
1,
2,
3
],
"label": "bod",
"score": 1,
"text": "脊髓脊膜"
},
{
"indices": [
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "双下肢瘫痪"
},
{
"indices": [
19,
20,
21,
22,
23
],
"label": "sym",
"score": 1,
"text": "大小便失禁"
},
{
"indices": [
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "大小便"
}
] |