Zar H J, Hussey G
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.
Ann Trop Paediatr. 2001 Mar;21(1):15-9.
We investigated the frequency of finger clubbing in 150 HIV-infected children consecutively hospitalized for acute pneumonia in South Africa and described associated clinical, laboratory and radiological features. Clubbing occurred in 30 of 150 (20%) HIV-infected children compared with one of 99 (1%) HIV-negative control patients, p < 0.001. Clubbing was associated with lower presenting heart and respiratory rates and enlarged parotid glands. Total and CD4 + lymphocytes, CD4:CD8 ratio and LDH were lower in children with clubbing, but serum protein and gammaglobulin were higher. No differences in the prevalence or type of microbial pathogens were found between the two groups. Clubbing was associated with a radiological diagnosis of LIP. Children with clubbing had a lower in-hospital mortality rate than those without clubbing (6.7% vs 24.2%, p = 0.035). In geographical areas with high HIV seroprevalence rates, the presence of clubbing in a child hospitalized for respiratory disease should raise the suspicion of HIV infection.
我们对南非150名因急性肺炎连续住院的HIV感染儿童的杵状指发生频率进行了调查，并描述了相关的临床、实验室和放射学特征。150名HIV感染儿童中有30名（20%）出现杵状指，而99名HIV阴性对照患者中有1名（1%）出现杵状指，p<0.001。杵状指与较低的初始心率和呼吸频率以及腮腺肿大有关。出现杵状指的儿童总淋巴细胞和CD4+淋巴细胞、CD4:CD8比值及乳酸脱氢酶较低，但血清蛋白和γ球蛋白较高。两组之间微生物病原体的患病率或类型没有差异。杵状指与淋巴细胞间质性肺炎的放射学诊断有关。出现杵状指的儿童住院死亡率低于未出现杵状指的儿童（6.7%对24.2%，p=0.035）。在HIV血清阳性率高的地理区域，因呼吸系统疾病住院的儿童出现杵状指应引起对HIV感染的怀疑。
