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目的探讨猫抓病的临床特征及诊断方法。方法回顾性分析8例猫抓病患者的流行病学资料、临床表现、辅助检查结果和诊断等。结果 8例中,1例成年患者长期喂养流浪猫并有明确被猫抓伤史,2例患儿有明确长期与猫、狗密切接触史。8例患者均表现为淋巴结肿大或局部肿块,质地中等或硬。8例患者中,4例患者单核细胞百分比升高,2例患者血小板升高,2例患者乳酸脱氢酶升高,3例患者血沉加快,1例患者进行了淋巴细胞亚群检测:CD3~+CD8~+细胞和CD3~+CD56~+细胞偏高,CD3~+CD4~+细胞和CD3~-CD19~+细胞偏低。入院疑诊淋巴瘤或淋巴结炎4例,腮腺或颌下腺肿瘤3例,发热待查1例。3例患者局部麻醉下行淋巴结活检手术,另外5例患者全身麻醉下接受肿块切除术或腮腺切除术。结论对于淋巴结肿大的患者,除了要鉴别肿瘤性疾病、结核感染和反应性淋巴结炎等,还应多关注猫、狗等宠物的接触史,警惕猫抓病的发生。
Objective To investigate the clinical features and diagnosis of cat scratch disease. Methods The epidemiological data, clinical manifestations, auxiliary examination results and diagnosis of 8 cat scratching patients were retrospectively analyzed. Results In 8 cases, 1 adult patient was fed stray cats for a long time and had a clear history of scratching the cats. Two children had a clear history of close contact with cats and dogs for a long time. All 8 patients showed swollen lymph nodes or local mass with medium or hard texture. Of the 8 patients, the percentage of monocytes was increased in 4 patients, thrombocytopenia in 2 patients, lactate dehydrogenase in 2 patients, erythrocyte sedimentation rate in 3 patients and lymphocyte subsets in 1 patient: CD3 ~ + CD8 ~ + cells and CD3 ~ + CD56 ~ + cells were high, CD3 ~ + CD4 ~ + cells and CD3 ~ -CD19 ~ + cells were low. 4 cases of suspected lymphomas or lymphadenitis were admitted to hospital, 3 cases of parotid gland or submandibular gland tumor, and 1 case had fever. Three patients underwent local lymph node biopsy under local anesthesia and the other five underwent generalized lump resection or parotidectomy under general anesthesia. Conclusion In patients with lymphadenopathy, we should pay more attention to the contact history of cats and dogs and other pets in addition to the identification of neoplastic diseases, tuberculosis and reactive lymphadenitis, and be alert to the cat scratching disease.