Gladtke E, Schauseil-Zipf U
Universitäts-Kinderklinik Köln.
Monatsschr Kinderheilkd. 1987 Oct;135(10):699-704.
Clinical course, laboratory findings and histopathological features of Reye's syndrome as described. Etiological and pathogenetic aspects are still under discussion although a viral infection preceding Reye's syndrome is a very common finding. Preceding Influenza B, Influenza A and varicella infections were most often seen in the United States. A genetic disposition seems to exists in some cases. Exogenic factors of pathogenetic relevances are aflatoxin, emulging agents, insecticides, paracetamol, acetylsalicylic acid and valproate. In the United States and Great Britain the incidence of Reye's syndrome is about ten times higher than in other European countries, as demonstrated by reports from Spain, Denmark and France. Results of an inquiry in Western Germany on Reye's syndrome between 1983 and 1985 are presented. 99 major pediatric hospitals were included into the study. Clinical data were obtained from 85 hospitals. The incidence of Reye's syndrome in Western Germany during 1983-1985 was 0.04-0.05 cases per 100,000 children under 18 years. 15 cases of Reye's syndrome were reported, i.e. an average of 5 cases per year. 8 children died. 3 patients had been treated with acetylsalicylic acid and 2 patients with paracetamol shortly before the onset of the disease.
文中描述了瑞氏综合征的临床病程、实验室检查结果及组织病理学特征。尽管瑞氏综合征之前出现病毒感染是很常见的情况,但病因和发病机制仍在讨论中。在美国,之前感染乙型流感、甲型流感和水痘最为常见。在某些情况下似乎存在遗传易感性。具有发病学相关性的外源性因素有黄曲霉毒素、乳化剂、杀虫剂、对乙酰氨基酚、乙酰水杨酸和丙戊酸盐。如西班牙、丹麦和法国的报告所示,在美国和英国,瑞氏综合征的发病率比其他欧洲国家高约十倍。本文展示了1983年至1985年在西德进行的一项关于瑞氏综合征的调查结果。99家主要儿科医院被纳入该研究。临床数据来自85家医院。1983 - 1985年期间,西德瑞氏综合征的发病率为每10万名18岁以下儿童中有0.04 - 0.05例。共报告了15例瑞氏综合征病例,即平均每年5例。8名儿童死亡。3例患者在疾病发作前不久曾服用乙酰水杨酸,2例患者曾服用对乙酰氨基酚。