text stringlengths 4 4.87k | entities list |
|---|---|
肾脏异位的分类根据肾脏所处的具体位置而定。 | [
{
"id": 0,
"entity": "肾脏异位",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
}
] |
异位肾在上述位置的分布上无明显突出之处，比较均匀。 | [
{
"id": 0,
"entity": "异位肾",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
}
] |
异位肾一般较正常为小，外形上可与正常有一些区别，但结构多正常，一般是直立的，也可侧转90°呈水平位。 | [
{
"id": 0,
"entity": "异位肾",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
}
] |
25%是由于Ⅲ级以上的膀胱输尿管反流引起的，另25%是由于肾旋转不良引起。 | [
{
"id": 0,
"entity": "肾旋转不良",
"start_offset": 29,
"end_offset": 34,
"label": "dis"
}
] |
异位肾的动脉供应依其所处的位置而定，可发自腹主动脉的末端或分叉处，也可来自髂总及髂外动脉。 | [
{
"id": 0,
"entity": "异位肾",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "腹主动脉",
"start_offset": 21,
"end_offset": 25,
"label": "bod"
},
{
"id": 2,
"entity": "髂总",
"start_offset": 37,
"end_offset": 39,
"label": "bod"
... |
患儿多伴生殖系统畸形，如女孩中的双角子宫、单角子宫、子宫缺如、阴道缺如和重复阴道等。 | [
{
"id": 0,
"entity": "生殖系统畸形",
"start_offset": 4,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "双角子宫",
"start_offset": 16,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "单角子宫",
"start_offset": 21,
"end_offset": 25,
"label": "... |
除了肾积水和肾结石外，异位肾并不意味具有更多的其他问题。 | [
{
"id": 0,
"entity": "肾积水",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "肾结石",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
},
{
"id": 2,
"entity": "异位肾",
"start_offset": 11,
"end_offset": 14,
"label": "dis"
}... |
但异位肾失去了肋骨的保护，易受外伤。 | [
{
"id": 0,
"entity": "异位肾",
"start_offset": 1,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "肋骨",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
}
] |
有报告提出由于异位肾的血供异常而出现肾血管性高血压。 | [
{
"id": 0,
"entity": "异位肾",
"start_offset": 7,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "肾血管性高血压",
"start_offset": 18,
"end_offset": 25,
"label": "dis"
}
] |
第九节链球菌感染一、A族链球菌感染A族链球菌（groupAstreptococcic，GAS）又称化脓性链球菌（streptococcuspyogenes），是一种常见的革兰阳性致病菌，GAS感染可以引起多种疾病，从急性咽炎、扁桃体炎到严重的侵袭性感染如坏死性筋膜炎和中毒性休克综合征，无菌性后遗症如风湿热、肾小球肾炎等。 | [
{
"id": 0,
"entity": "链球菌感染",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "A族链球菌感染",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "A族链球菌",
"start_offset": 17,
"end_offset": 22,
"label":... |
【病原学】链球菌是革兰阳性球菌，常呈对状或链状生长，以它溶解红细胞的能力分类，可分为完全溶血（β溶血）、部分溶血（又称草绿色溶血，α溶血）和不溶血（γ溶血）三种。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 5,
"end_offset": 8,
"label": "mic"
},
{
"id": 1,
"entity": "革兰阳性球菌",
"start_offset": 9,
"end_offset": 15,
"label": "mic"
},
{
"id": 2,
"entity": "红细胞",
"start_offset": 30,
"end_offset": 33,
"label": "bod"... |
因为溶血本身不构成致病性，兰斯菲尔德进一步按细胞壁的碳水化合物成分的不同将链球菌分为A-H和K-V族。 | [
{
"id": 0,
"entity": "细胞壁",
"start_offset": 22,
"end_offset": 25,
"label": "bod"
},
{
"id": 1,
"entity": "碳水化合物成分",
"start_offset": 26,
"end_offset": 33,
"label": "bod"
},
{
"id": 2,
"entity": "链球菌",
"start_offset": 37,
"end_offset": 40,
"label": "... |
A族β溶血性链球菌细胞壁由明显的三层结构所组成，外层部分包含几种抗原蛋白，其中非常重要的是M蛋白。 | [
{
"id": 0,
"entity": "A族β溶血性链球菌细胞壁",
"start_offset": 0,
"end_offset": 12,
"label": "bod"
},
{
"id": 1,
"entity": "抗原蛋白",
"start_offset": 32,
"end_offset": 36,
"label": "bod"
},
{
"id": 2,
"entity": "M蛋白",
"start_offset": 45,
"end_offset": 48,
"labe... |
A族β溶血性链球菌按其M蛋白抗原的不同可分为80多个血清型，M蛋白是细菌主要的毒力因子，它可黏附于人类上皮细胞和抵抗吞噬作用。 | [
{
"id": 0,
"entity": "A族β溶血性链球菌",
"start_offset": 0,
"end_offset": 9,
"label": "mic"
},
{
"id": 1,
"entity": "M蛋白抗原",
"start_offset": 11,
"end_offset": 16,
"label": "mic"
},
{
"id": 2,
"entity": "血清",
"start_offset": 26,
"end_offset": 28,
"label": ... |
细胞壁的另一种成分即脂胞壁酸，是另一种毒力因子，它可通过上皮细胞表面的纤维素加速细菌作用在黏膜、皮肤上。 | [
{
"id": 0,
"entity": "细胞壁",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "脂胞壁酸",
"start_offset": 10,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "上皮细胞",
"start_offset": 28,
"end_offset": 32,
"label": "bod"... |
而透明质酸荚膜抵抗吞噬作用，进一步增加细菌毒力。 | [
{
"id": 0,
"entity": "透明质酸荚膜",
"start_offset": 1,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "细菌",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
}
] |
获得性免疫是直接针对M蛋白的。 | [
{
"id": 0,
"entity": "M蛋白",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
}
] |
链球菌产生毒素、酶和溶血素，当在人体组织中生长时，A族β溶血性链球菌释放约有20多种细胞外抗原成分。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "毒素",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "酶",
"start_offset": 8,
"end_offset": 9,
"label": "bod"
},
{... |
在这些细胞外产物中，致热性红斑毒素（A、B和C）、链球菌素O和S、链激酶、脱氧核糖核酸酶和蛋白酶，具有很重要的临床意义。 | [
{
"id": 0,
"entity": "细胞",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "致热性红斑毒素",
"start_offset": 10,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "链球菌素O",
"start_offset": 25,
"end_offset": 30,
"label": "b... |
致热性红斑毒素可引起猩红热的皮疹和中毒休克样综合征中的休克症状。 | [
{
"id": 0,
"entity": "致热性红斑毒素",
"start_offset": 0,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "猩红热",
"start_offset": 10,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "皮疹",
"start_offset": 14,
"end_offset": 16,
"label": "dis... |
链球菌素S引起细胞的粘连，破坏中性粒细胞和血小板的膜壁结构。 | [
{
"id": 0,
"entity": "链球菌素S",
"start_offset": 0,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "细胞",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "中性粒细胞",
"start_offset": 15,
"end_offset": 20,
"label": "bod"
... |
链球菌素O溶解红细胞，并对中性粒细胞有毒性作用。 | [
{
"id": 0,
"entity": "链球菌素O",
"start_offset": 0,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "红细胞",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "中性粒细胞",
"start_offset": 13,
"end_offset": 18,
"label": "bod... |
链球菌素O和S使得这一β溶血性链球菌菌株产生清楚的溶血环。 | [
{
"id": 0,
"entity": "链球菌素O",
"start_offset": 0,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "β溶血性链球菌",
"start_offset": 11,
"end_offset": 18,
"label": "mic"
},
{
"id": 2,
"entity": "溶血环",
"start_offset": 25,
"end_offset": 28,
"label": "... |
细胞外的消化酶使得该细菌能在组织中迅速蔓延，例如：链激酶溶解纤维蛋白，DNA酶帮助脓液液化，透明质酸酶可帮助细菌穿透基底膜组织，蛋白酶同严重侵袭性感染造成的组织损害有关。 | [
{
"id": 0,
"entity": "细胞",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "消化酶",
"start_offset": 4,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "细菌",
"start_offset": 10,
"end_offset": 12,
"label": "bod"
},
... |
抗链球菌素O抗体（ASO）、抗DNaseB、透明质酸酶和链激酶抗体在A族链球菌疾病的血清学诊断中有一定作用。 | [
{
"id": 0,
"entity": "抗链球菌素O抗体",
"start_offset": 0,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "ASO",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "抗DNaseB",
"start_offset": 14,
"end_offset": 21,
"label":... |
M型特异性抗体在感染后的4～8周可检测出来，而抗生素的治疗可阻断这一反应。 | [
{
"id": 0,
"entity": "M型特异性抗体",
"start_offset": 0,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "抗生素",
"start_offset": 23,
"end_offset": 26,
"label": "bod"
}
] |
【流行病学】由A族链球菌引起化脓性和非化脓性并发症的发病率在20世纪80年代晚期和90年代呈增加趋势。 | [
{
"id": 0,
"entity": "A族链球菌",
"start_offset": 7,
"end_offset": 12,
"label": "mic"
},
{
"id": 1,
"entity": "非化脓性并发症",
"start_offset": 18,
"end_offset": 25,
"label": "dis"
}
] |
这种严重链球菌感染性疾病的复燃的确切原因尚不知道，可能同流行菌株较以前更具有毒力有关。 | [
{
"id": 0,
"entity": "严重链球菌感染性疾病",
"start_offset": 2,
"end_offset": 12,
"label": "dis"
}
] |
A族链球菌是人类正常口咽部的菌群，儿童带菌率是15%～20%，发病率取决于小儿的年龄、季节、气候和地理位置，以及和感染者接触的程度有关。 | [
{
"id": 0,
"entity": "A族链球菌",
"start_offset": 0,
"end_offset": 5,
"label": "mic"
},
{
"id": 1,
"entity": "口咽部",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
}
] |
一般来说，婴儿期发病率最低，可能是经胎盘获得型特异性抗体的保护作用，也可能是婴儿期咽部尚缺乏同链球菌结合的受体。 | [
{
"id": 0,
"entity": "胎盘",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
},
{
"id": 1,
"entity": "特异性抗体",
"start_offset": 23,
"end_offset": 28,
"label": "bod"
},
{
"id": 2,
"entity": "咽部",
"start_offset": 41,
"end_offset": 43,
"label": "bod"... |
小于6岁儿童的链球菌皮肤感染是很常见的，5～15岁儿童链球菌性咽炎最常见，小于3岁的小儿链球菌疾病，包括猩红热不常见。 | [
{
"id": 0,
"entity": "链球菌皮肤感染",
"start_offset": 7,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "链球菌性咽炎",
"start_offset": 27,
"end_offset": 33,
"label": "dis"
},
{
"id": 2,
"entity": "小儿链球菌疾病",
"start_offset": 42,
"end_offset": 49,
"lab... |
严重的侵袭性的A族链球菌感染可在任何年龄组出现。 | [
{
"id": 0,
"entity": "A族链球菌感染",
"start_offset": 7,
"end_offset": 14,
"label": "dis"
}
] |
链球菌咽炎在温带地区发病率较高，发病率和严重程度在寒冷季节增加，尤其在学龄儿童。 | [
{
"id": 0,
"entity": "链球菌咽炎",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
}
] |
脓疱病在热带和温热气候时最易发生。 | [
{
"id": 0,
"entity": "脓疱病",
"start_offset": 0,
"end_offset": 3,
"label": "dis"
}
] |
A族β溶血性链球菌是经飞沫传播的，咽部带菌者是常见的传染源，感染也可经接触破损的皮肤伤口，或经食物、牛奶和水来传播。 | [
{
"id": 0,
"entity": "A族β溶血性链球菌",
"start_offset": 0,
"end_offset": 9,
"label": "mic"
},
{
"id": 1,
"entity": "咽部",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "皮肤",
"start_offset": 40,
"end_offset": 42,
"label": "bo... |
链球菌的感染常和家庭、学校、部队或拥挤的居住条件有关，破损的皮肤易于感染脓皮疹或脓疱疹，如水痘就可造成皮肤的破损，它不仅是链球菌感染的侵入途径，还使得宿主对其感染的反应性降低。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 30,
"end_offset": 32,
"label": "bod"
},
{
"id": 2,
"entity": "脓皮疹",
"start_offset": 36,
"end_offset": 39,
"label": "dis"
... |
在链球菌感染的急性期3～5天内是极易传染给他人的。 | [
{
"id": 0,
"entity": "链球菌感染",
"start_offset": 1,
"end_offset": 6,
"label": "dis"
}
] |
而在带菌期传染力减弱，型特异性免疫力可以由带菌或明显感染所诱导，链球菌在成人期随着对更多流行的血清型产生了免疫力，患病的危险大大减少了。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 32,
"end_offset": 35,
"label": "mic"
},
{
"id": 1,
"entity": "血清",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
}
] |
【发病机制】在吸入或食入链球菌后，细菌通过表面原纤维、细胞壁脂胞壁酸附着在呼吸道上皮细胞上，原纤维含有抗吞噬细胞的特异性M蛋白的抗原决定簇，M蛋白同荚膜透明质酸一起抵抗吞噬作用，细胞外消化性酶通过干扰局部血栓形成（链球菌素）和脓液形成（DNA酶）使得感染的蔓延加快；同时蛋白酶、透明质酸酶增加了对结缔组织的消化。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 12,
"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "细菌",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "表面原纤维",
"start_offset": 21,
"end_offset": 26,
"label": "bod... |
局部炎症后的化脓性并发症如扁桃体周围脓肿咽后壁脓肿中耳炎、鼻窦炎、淋巴管（淋巴结炎）的蔓延和菌血症（败血症、肺炎、骨髓炎）。 | [
{
"id": 0,
"entity": "局部炎症",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "化脓性并发症",
"start_offset": 6,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "扁桃体",
"start_offset": 13,
"end_offset": 16,
"label": "bod... |
引起猩红热临床症状的链球菌同非致热原外毒素菌株相似，只是增加猩红热样皮疹，血清学明确的致热原外毒素（A～C），在无免疫力的个体产生皮疹，皮疹可因宿主产生特异性的抗毒素抗体而减少。 | [
{
"id": 0,
"entity": "猩红热",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "链球菌",
"start_offset": 10,
"end_offset": 13,
"label": "mic"
},
{
"id": 2,
"entity": "非致热原外毒素菌株",
"start_offset": 14,
"end_offset": 23,
"label": "... |
这些毒素具有致热原性和细胞毒性，它们增加了外毒素的效果，并同中毒休克样症状产生有关。 | [
{
"id": 0,
"entity": "毒素",
"start_offset": 2,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "细胞",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "外毒素",
"start_offset": 21,
"end_offset": 24,
"label": "bod"
}... |
链球菌致热外毒素A有部分氨基酸同葡萄球菌肠毒素B同源，而后者同葡萄球菌中毒休克综合征的发生有关。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "致热外毒素",
"start_offset": 3,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "氨基酸",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
... |
【临床表现】最常见的感染部位是呼吸道、皮肤、软组织和血液。 | [
{
"id": 0,
"entity": "呼吸道",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 19,
"end_offset": 21,
"label": "bod"
},
{
"id": 2,
"entity": "软组织",
"start_offset": 22,
"end_offset": 25,
"label": "bod"
... |
常见的疾病有：咽炎、扁桃体炎、肺炎、皮肤感染、阴道炎、肛周疾病、败血症和菌血症，以及猩红热、链球菌中毒休克综合征、严重的侵袭性链球菌疾病。 | [
{
"id": 0,
"entity": "咽炎",
"start_offset": 7,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "扁桃体炎",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "肺炎",
"start_offset": 15,
"end_offset": 17,
"label": "dis"
... |
（一）咽炎、扁桃体炎6个月～3岁的婴幼儿多见，主要表现为鼻咽炎、流清涕、低热，常见上唇周围表皮剥脱鼻咽炎临床上不易与其他病因的呼吸道感染鉴别。 | [
{
"id": 0,
"entity": "咽炎",
"start_offset": 3,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "扁桃体炎",
"start_offset": 6,
"end_offset": 10,
"label": "dis"
},
{
"id": 2,
"entity": "鼻咽炎",
"start_offset": 28,
"end_offset": 31,
"label": "dis"
... |
3～12岁小儿常患急性咽炎、急性滤泡性扁桃体炎、化脓性扁桃体炎，患儿有发热、咽痛、轻重不等的感染中毒全身症状。 | [
{
"id": 0,
"entity": "急性咽炎",
"start_offset": 9,
"end_offset": 13,
"label": "dis"
},
{
"id": 1,
"entity": "急性滤泡性扁桃体炎",
"start_offset": 14,
"end_offset": 23,
"label": "dis"
},
{
"id": 2,
"entity": "化脓性扁桃体炎",
"start_offset": 24,
"end_offset": 31,
"lab... |
（二）皮肤感染由A族β溶血性族链球菌引起的皮肤感染最常见的是表皮层脓疱病。 | [
{
"id": 0,
"entity": "皮肤感染",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "A族β溶血性族链球菌",
"start_offset": 8,
"end_offset": 18,
"label": "mic"
},
{
"id": 2,
"entity": "皮肤感染",
"start_offset": 21,
"end_offset": 25,
"label":... |
细菌在无破损的皮肤上生长约10天，在虫咬、划伤、小的创伤后，细菌可在皮下繁殖，发展成为脓疱病、深脓疱和蜂窝织炎。 | [
{
"id": 0,
"entity": "细菌",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "细菌",
"start_offset": 30,
"end_offset": 32,
"label": "bod"
},
... |
皮肤的脓疱病感染株常和患者咽部携带的菌株相同。 | [
{
"id": 0,
"entity": "皮肤",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "脓疱病",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 2,
"entity": "咽部",
"start_offset": 13,
"end_offset": 15,
"label": "bod"
}
] |
深部软组织感染可以出现如丹毒，它是一种急性、易区别的皮肤感染，同时伴淋巴管炎，可以累及面部，常常和咽炎有关。 | [
{
"id": 0,
"entity": "深部软组织感染",
"start_offset": 0,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "丹毒",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "皮肤感染",
"start_offset": 26,
"end_offset": 30,
"label": "di... |
（三）猩红热猩红热（scarletfever）常见于3岁以上小儿，为急性呼吸道传染病。 | [
{
"id": 0,
"entity": "猩红热",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "猩红热",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
},
{
"id": 2,
"entity": "scarletfever",
"start_offset": 10,
"end_offset": 22,
"label": ... |
以发热、咽炎及皮疹为特征，此病可由不同型的A族β溶血性链球菌引起，其细菌的致热毒素有A、B、C三种。 | [
{
"id": 0,
"entity": "发热",
"start_offset": 1,
"end_offset": 3,
"label": "dis"
},
{
"id": 1,
"entity": "咽炎",
"start_offset": 4,
"end_offset": 6,
"label": "dis"
},
{
"id": 2,
"entity": "皮疹",
"start_offset": 7,
"end_offset": 9,
"label": "dis"
},
{... |
感染其中一种后，再遇到其他任一种，仍可发生第二次或第三次猩红热，但这种机会很少。 | [
{
"id": 0,
"entity": "猩红热",
"start_offset": 28,
"end_offset": 31,
"label": "dis"
}
] |
起病急骤，有寒战、发热、全身不适、咽痛和皮肤出现弥漫性猩红色、约针头大小的丘疹，触之呈粗砂纸样。 | [
{
"id": 0,
"entity": "寒战",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "发热",
"start_offset": 9,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "全身不适",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
}... |
体格检查：面颊部潮红口周围皮肤苍白口周苍白圈。 | [
{
"id": 0,
"entity": "体格检查",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "面颊部",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "面颊部潮红",
"start_offset": 5,
"end_offset": 10,
"label": "sym"
... |
咽及扁桃体显著充血可见脓性渗出物。 | [
{
"id": 0,
"entity": "咽",
"start_offset": 0,
"end_offset": 1,
"label": "bod"
},
{
"id": 1,
"entity": "扁桃体",
"start_offset": 2,
"end_offset": 5,
"label": "bod"
},
{
"id": 2,
"entity": "咽及扁桃体显著充血",
"start_offset": 0,
"end_offset": 9,
"label": "sym"
... |
舌质红舌乳头红肿如草莓舌颈部及颌下淋巴结增大有触痛。 | [
{
"id": 0,
"entity": "舌质",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "舌质红",
"start_offset": 0,
"end_offset": 3,
"label": "sym"
},
{
"id": 2,
"entity": "舌乳头",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
},
... |
于皮肤皱褶处如腋窝、肘、腹股沟等处，皮疹密集、色深红，其间有针头大小出血点，形成深红色横行“帕氏症”（Pastia’ssign）。 | [
{
"id": 0,
"entity": "皮肤",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "腋窝",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "肘",
"start_offset": 10,
"end_offset": 11,
"label": "bod"
},
... |
（四）链球菌中毒休克样综合征链球菌中毒休克样综合征（TSS）这一疾病是同菌株产生致热外毒素有关，其特征是低血压，伴随多器官、系统功能障碍葡萄球菌中毒休克综合征相区别。 | [
{
"id": 0,
"entity": "链球菌中毒休克样综合征",
"start_offset": 3,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "链球菌中毒休克样综合征",
"start_offset": 14,
"end_offset": 25,
"label": "dis"
},
{
"id": 2,
"entity": "TSS",
"start_offset": 26,
"end_offset": 29,
... |
经常是有A族链球菌感染的病灶，如菌血症、肺炎、蜂窝织炎，而咽炎常不存在，咽培养的结果可以是阴性的，但可以从其他部位分离出细菌。 | [
{
"id": 0,
"entity": "A族链球菌感染",
"start_offset": 4,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "菌血症",
"start_offset": 16,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "肺炎",
"start_offset": 20,
"end_offset": 22,
"label": "di... |
（五）严重侵袭性链球菌疾病是一组非常严重的侵袭性A族链球菌疾病，包括脓毒败血症、重症的猩红热、坏死性筋膜炎、TSS和败血症，在世界范围内，它们的发病率已在增加，其原因可能是因为更有毒性的菌株的流行。 | [
{
"id": 0,
"entity": "严重侵袭性链球菌疾病",
"start_offset": 3,
"end_offset": 13,
"label": "dis"
},
{
"id": 1,
"entity": "侵袭性A族链球菌疾病",
"start_offset": 21,
"end_offset": 31,
"label": "dis"
},
{
"id": 2,
"entity": "脓毒败血症",
"start_offset": 34,
"end_offset": 39,
... |
这些菌株可能同在18世纪引起世界范围内暴发性脓毒败血症的菌株相似。 | [
{
"id": 0,
"entity": "脓毒败血症",
"start_offset": 22,
"end_offset": 27,
"label": "dis"
}
] |
这些严重形式的A族链球菌疾病需要早期认识和有效的治疗。 | [
{
"id": 0,
"entity": "A族链球菌疾病",
"start_offset": 7,
"end_offset": 14,
"label": "dis"
}
] |
10%～20%的正常学龄儿童咽培养可有A族链球菌出现，这些携带者没有发生感染和风湿热的危险。 | [
{
"id": 0,
"entity": "咽培养",
"start_offset": 14,
"end_offset": 17,
"label": "pro"
},
{
"id": 1,
"entity": "A族链球菌",
"start_offset": 19,
"end_offset": 24,
"label": "mic"
},
{
"id": 2,
"entity": "风湿热",
"start_offset": 39,
"end_offset": 42,
"label": "di... |
有30%患有咽痛的儿童咽培养可以阳性，仅有一半人有血清抗体增高，说明有感染，而不是带菌者。 | [
{
"id": 0,
"entity": "咽痛",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "咽培养",
"start_offset": 11,
"end_offset": 14,
"label": "pro"
},
{
"id": 2,
"entity": "血清抗体",
"start_offset": 25,
"end_offset": 29,
"label": "bod"
... |
链球菌咽炎患儿发病年龄多在5岁以上，有发热、咽部渗出物颈前淋巴结肿大猩红热样皮疹和A族链球菌暴露接触史。 | [
{
"id": 0,
"entity": "链球菌咽炎",
"start_offset": 0,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "发热",
"start_offset": 19,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "咽部",
"start_offset": 22,
"end_offset": 24,
"label": "bod"
... |
但是许多患有急性感染的小儿可能仅有轻度症状，通过临床不能判断患A族链球菌感染，需有咽培养和抗原检测来明确诊断。 | [
{
"id": 0,
"entity": "A族链球菌感染",
"start_offset": 31,
"end_offset": 38,
"label": "dis"
},
{
"id": 1,
"entity": "咽培养",
"start_offset": 41,
"end_offset": 44,
"label": "pro"
},
{
"id": 2,
"entity": "抗原检测",
"start_offset": 45,
"end_offset": 49,
"label": ... |
【实验室检查】（一）咽培养咽培养是非常有价值的实验室检查，帮助患有扁桃体炎和咽炎患者明确诊断。 | [
{
"id": 0,
"entity": "实验室检查",
"start_offset": 1,
"end_offset": 6,
"label": "pro"
},
{
"id": 1,
"entity": "咽培养",
"start_offset": 10,
"end_offset": 13,
"label": "pro"
},
{
"id": 2,
"entity": "咽培养",
"start_offset": 13,
"end_offset": 16,
"label": "pro"... |
扁桃体和咽后壁有力地拭抹对于获得足够的标本是必要的，选择培养基以羊血培养基效果好，在3%的双氧水中无气泡产生（触酶试验阴性），并有β溶血菌落可以定为链球菌，而A族链球菌的生长可被杆菌肽纸片抑制；乳胶凝集试验也可证实。 | [
{
"id": 0,
"entity": "扁桃体",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "咽后壁",
"start_offset": 4,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "双氧水",
"start_offset": 45,
"end_offset": 48,
"label": "dru"
}... |
因为溶血性链球菌常常栖居在正常儿童的咽部，因此，在咽炎患儿的咽部分离出A族链球菌不一定说明炎症就是由这一病原引起的。 | [
{
"id": 0,
"entity": "溶血性链球菌",
"start_offset": 2,
"end_offset": 8,
"label": "mic"
},
{
"id": 1,
"entity": "咽部",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "咽炎",
"start_offset": 25,
"end_offset": 27,
"label": "dis"
... |
若细菌由中、重度渗出性咽炎的患儿标本中分离，并且他们的腭部有瘀斑和颈部淋巴结炎，这一诊断则是确定的。 | [
{
"id": 0,
"entity": "细菌",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "咽炎",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "腭部",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
},... |
到目前为止，细菌抗原的快速检测的敏感性尚不高，但特异性较好。 | [
{
"id": 0,
"entity": "细菌抗原",
"start_offset": 6,
"end_offset": 10,
"label": "mic"
}
] |
（二）血常规周围血白细胞计数可以增高，也可以不增高，白细胞增加可出现在许多细菌感染性疾病。 | [
{
"id": 0,
"entity": "血常规",
"start_offset": 3,
"end_offset": 6,
"label": "ite"
},
{
"id": 1,
"entity": "血白细胞计数",
"start_offset": 8,
"end_offset": 14,
"label": "ite"
},
{
"id": 2,
"entity": "白细胞",
"start_offset": 26,
"end_offset": 29,
"label": "bod"... |
同样，血沉和C反应蛋白的增高也不能作为诊断的依据。 | [
{
"id": 0,
"entity": "血沉",
"start_offset": 3,
"end_offset": 5,
"label": "ite"
},
{
"id": 1,
"entity": "C反应蛋白",
"start_offset": 6,
"end_offset": 11,
"label": "ite"
}
] |
（三）免疫学反应1.ASO抗体水平的检测在病程的3～6周，80%链球菌咽炎患儿ASO抗体滴度大于166todd单位。 | [
{
"id": 0,
"entity": "ASO抗体",
"start_offset": 10,
"end_offset": 15,
"label": "bod"
},
{
"id": 1,
"entity": "链球菌咽炎",
"start_offset": 32,
"end_offset": 37,
"label": "dis"
},
{
"id": 2,
"entity": "ASO抗体滴度",
"start_offset": 39,
"end_offset": 46,
"label... |
通过早期、有效抗生素的应用，这一反应可以被减弱或消除。 | [
{
"id": 0,
"entity": "抗生素",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
}
] |
ASO滴度在风湿热患者可以很高。 | [
{
"id": 0,
"entity": "ASO滴度",
"start_offset": 0,
"end_offset": 5,
"label": "ite"
},
{
"id": 1,
"entity": "风湿热",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
}
] |
相反，脓疱病患者这一抗体是弱阳性或很低。 | [
{
"id": 0,
"entity": "脓疱病",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
}
] |
在肾小球肾炎的患者这一抗体反应个体差异较大。 | [
{
"id": 0,
"entity": "肾小球肾炎",
"start_offset": 1,
"end_offset": 6,
"label": "dis"
}
] |
2.抗DNA酶B抗体（ADB）水平的检测患有脓疱病的患儿可能对其链球菌细胞外产物的刺激具有强烈的反应。 | [
{
"id": 0,
"entity": "抗DNA酶B抗体",
"start_offset": 2,
"end_offset": 10,
"label": "bod"
},
{
"id": 1,
"entity": "ADB",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "脓疱病",
"start_offset": 22,
"end_offset": 25,
"label": "... |
感染发生6～8周时抗体水平在链球菌性脓疱病患儿开始增高，许多有链球菌咽炎者也可产生针对这一酶的抗体。 | [
{
"id": 0,
"entity": "链球菌性脓疱病",
"start_offset": 14,
"end_offset": 21,
"label": "dis"
},
{
"id": 1,
"entity": "链球菌咽炎",
"start_offset": 31,
"end_offset": 36,
"label": "dis"
},
{
"id": 2,
"entity": "酶",
"start_offset": 45,
"end_offset": 46,
"label": "... |
3.脓疱病和咽炎患者也可产生针对透明质酸酶抗体反应，但这一反应不像ASO反应那样有规律。 | [
{
"id": 0,
"entity": "脓疱病",
"start_offset": 2,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "咽炎",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 2,
"entity": "透明质酸酶抗体",
"start_offset": 16,
"end_offset": 23,
"label": "bod"
... |
当考虑患儿有近期感染时，应该测定多种链球菌产物的抗体反应滴度。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 18,
"end_offset": 21,
"label": "mic"
}
] |
4.快速抗原检测法（rapidantigendetectiontest，RADT）诊断咽部GAS感染的正确性较高，具有简单快捷的优势，但对症状较轻或使用过抗生素治疗的患儿的诊断效能有所下降。 | [
{
"id": 0,
"entity": "快速抗原检测法",
"start_offset": 2,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "rapidantigendetectiontest",
"start_offset": 10,
"end_offset": 35,
"label": "pro"
},
{
"id": 2,
"entity": "RADT",
"start_offset": 36,
"end_offset... |
【鉴别诊断】（一）病毒性咽炎咽部细菌培养常阴性，而特异病毒培养可以阳性，血清特异性抗体可增加。 | [
{
"id": 0,
"entity": "病毒性咽炎",
"start_offset": 9,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "咽部细菌培养",
"start_offset": 14,
"end_offset": 20,
"label": "pro"
},
{
"id": 2,
"entity": "特异病毒培养",
"start_offset": 25,
"end_offset": 31,
"label"... |
（二）感染性单核细胞增多症其临床症状，末梢血非典型淋巴细胞存在，异嗜血细胞和EB病毒滴度增高都是此病的特征。 | [
{
"id": 0,
"entity": "感染性单核细胞增多症",
"start_offset": 3,
"end_offset": 13,
"label": "dis"
},
{
"id": 1,
"entity": "末梢血非典型淋巴细胞",
"start_offset": 19,
"end_offset": 29,
"label": "bod"
},
{
"id": 2,
"entity": "异嗜血细胞",
"start_offset": 32,
"end_offset": 37,
... |
（三）其他病原引起的急性咽炎如白喉、支原体感染等适当的咽培养和血清学检测可以排出这些疾病。 | [
{
"id": 0,
"entity": "急性咽炎",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "白喉",
"start_offset": 15,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "支原体感染",
"start_offset": 18,
"end_offset": 23,
"label": "di... |
（四）葡萄球菌皮肤感染链球菌性脓皮病应该同葡萄球菌皮肤感染相鉴别，两种细菌经常同时存在，培养是鉴别的最好方法。 | [
{
"id": 0,
"entity": "葡萄球菌皮肤感染",
"start_offset": 3,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "链球菌性脓皮病",
"start_offset": 11,
"end_offset": 18,
"label": "dis"
},
{
"id": 2,
"entity": "葡萄球菌皮肤感染",
"start_offset": 21,
"end_offset": 29,
"... |
（五）链球菌败血症、脑膜炎、化脓性关节炎和肺炎其病状无特异性，只有培养证实。 | [
{
"id": 0,
"entity": "链球菌败血症",
"start_offset": 3,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "脑膜炎",
"start_offset": 10,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "化脓性关节炎",
"start_offset": 14,
"end_offset": 20,
"label": "... |
【并发症】并发症一般反映链球菌从鼻咽部蔓延过程，引起鼻窦炎、中耳炎、乳突炎、颈淋巴结炎、咽后壁脓肿支气管肺炎。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 12,
"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "鼻咽部",
"start_offset": 16,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "鼻窦炎",
"start_offset": 26,
"end_offset": 29,
"label": "dis"... |
链球菌血源性传播可引起脑膜炎、骨髓炎或化脓性关节炎。 | [
{
"id": 0,
"entity": "链球菌",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "脑膜炎",
"start_offset": 11,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "骨髓炎",
"start_offset": 15,
"end_offset": 18,
"label": "dis"
... |
非化脓性晚期并发症包括风湿热和肾小球肾炎。 | [
{
"id": 0,
"entity": "非化脓性晚期并发症",
"start_offset": 0,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "风湿热",
"start_offset": 11,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "肾小球肾炎",
"start_offset": 15,
"end_offset": 20,
"label":... |
【治疗】治疗的目的是减轻症状，预防败血症、化脓和非化脓性并发症。 | [
{
"id": 0,
"entity": "败血症",
"start_offset": 17,
"end_offset": 20,
"label": "dis"
},
{
"id": 1,
"entity": "非化脓性并发症",
"start_offset": 24,
"end_offset": 31,
"label": "dis"
}
] |
青霉素是首选药物。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 0,
"end_offset": 3,
"label": "dru"
}
] |
迄今为止，所有A族链球菌菌株都对青霉素和许多头孢菌素敏感。 | [
{
"id": 0,
"entity": "A族链球菌",
"start_offset": 7,
"end_offset": 12,
"label": "mic"
},
{
"id": 1,
"entity": "青霉素",
"start_offset": 16,
"end_offset": 19,
"label": "dru"
},
{
"id": 2,
"entity": "头孢菌素",
"start_offset": 22,
"end_offset": 26,
"label": "dr... |
但在严重感染时推荐青霉素和克林霉素联合应用，对青霉素过敏时大环内酯类抗生素作为首选药物，但我国已经有大环内酯类高耐药率及高水平耐药的报道。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 9,
"end_offset": 12,
"label": "dru"
},
{
"id": 1,
"entity": "克林霉素",
"start_offset": 13,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "青霉素",
"start_offset": 23,
"end_offset": 26,
"label": "dru"... |
对红霉素耐药程度在不同国家和地区有明显差异，它取决于应用红霉素的广泛程度；克林霉素耐药株少见。 | [
{
"id": 0,
"entity": "红霉素",
"start_offset": 1,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "红霉素",
"start_offset": 28,
"end_offset": 31,
"label": "dru"
},
{
"id": 2,
"entity": "克林霉素",
"start_offset": 37,
"end_offset": 41,
"label": "dru"
... |
对于深部感染部位，A族链球菌生长缓慢时，青霉素治疗效果不好。 | [
{
"id": 0,
"entity": "A族链球菌",
"start_offset": 9,
"end_offset": 14,
"label": "mic"
},
{
"id": 1,
"entity": "青霉素",
"start_offset": 20,
"end_offset": 23,
"label": "dru"
}
] |
在血液和组织中青霉素的杀菌浓度维持至少10天，以便彻底杀死链球菌。 | [
{
"id": 0,
"entity": "青霉素",
"start_offset": 7,
"end_offset": 10,
"label": "dru"
},
{
"id": 1,
"entity": "链球菌",
"start_offset": 29,
"end_offset": 32,
"label": "mic"
}
] |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.