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这种类型的房性心动过速通常由单个异位自律病灶引起，而不是通常的折返机制。 | [
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有一简单方法识别这两种机制，即迷走或药物治疗时观察心电图。 | [
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折返机制时心动过速突然停止，自律性心动过速时心率逐渐减慢，然后又逐渐增快。 | [
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房性异位性心动过速较通常的折返性心动过速难以用药物控制。 | [
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（二）紊乱性或多源性房性心动过速特征为三种或以上的异位P波，三种或以上的PP间期，常见P波阻滞，PR间期不等。 | [
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这种心律失常最常发生在1岁以下的婴儿，通常无心脏病变，但有些病例可能与病毒性心肌炎有关。 | [
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这种类型的心律失常药物治疗难以奏效，常需多种药物联合应用。 | [
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（三）加速性交界性异位性心动过速（JET）为自律性（非折返性）心动过速，交界心率超过窦性心率，因而可出现房室分离。 | [
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这种心律失常最常见于心脏外科手术后早期，非常难以控制。 | [
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这些患儿的JET常未经特殊治疗而自发消失。 | [
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JET也可以是洋地黄中毒的表现，在这种情况下，洋地黄应停用。 | [
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术后JET胺碘酮治疗比较有效。 | [
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需长期用药的患儿可选用胺碘酮或索他洛尔。 | [
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参考文献1.TryggvasonK，ZhouJ，LiisaS，etal.MoleculargeneticsofAlportsyndrome.KidneyInt，1993，43（1）：38-442.ReedersST.MoleculargeneticsofhereditaryNephritis.KidneyInt，1992，42（3）：783-7833.KashtanCE，SzaboP，RichS，etal.TheAlportlocusassociatedwithadefectintypeIVcollagenNCIdomainmapstoregionXq21.3～q22.KidneyInt，1989，35：2054.KastanCE，... | [
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第六节脱落细胞学检查脱落细胞学是通过观察临床标本中脱落上皮细胞的形态和结构的变化，而诊断疾病的一门学科。 | [
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近年来随着各种标本采集、细胞学检查技术的提高，脱落细胞学得到了很大的发展。 | [
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诱导痰、纤维支气管镜下细胞刷涂片、支气管肺泡灌洗液（BALF）细胞成分检查等技术，大大提高了肺部疾病的检出率。 | [
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一、鼻咽部脱落细胞检查鼻咽部脱落细胞检查对病毒性呼吸道感染的诊断具有较重要的参考价值。 | [
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常通过鼻咽部负压吸引，收集脱落细胞，进行病毒分离、病毒抗原检测或核酸测定。 | [
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光学显微镜检查可见纤毛细胞坏变，即纤毛柱状上皮细胞体积增大、胞质淡染或着色不均匀，胞质固缩、碎裂等。 | [
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在感染的上皮细胞胞质和（或）胞核内，可有嗜酸性或嗜碱性包涵体。 | [
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第八节肺吸虫病肺吸虫病（paragonimiasis）由肺吸虫寄生于人体所引起。 | [
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临床症状以咯血为主。 | [
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但因虫体在胸腔内移行的途径及病变部位不同而异。 | [
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若囊性空洞已形成并与支气管相通时，出现血痰和少量咯血，但大量咯血少见。 | [
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典型的痰液呈饴糖样、巧克力样或黏稠的铁锈色。 | [
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转为慢性时，呈脓性痰伴血丝；咳嗽、咳痰逐渐加剧，活动后或晨起时可出现呼吸困难。 | [
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虫体寄生部位可涉及多处，尤以肺下叶多见。 | [
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有时伴胸水或气胸。 | [
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此外可累及中枢神经系统、肠壁、肝、脾、腹膜及皮下组织等，并引起相应症状。 | [
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有时可在痰和粪便中找到虫卵，对流免疫电泳、琼脂扩散、放射免疫电泳、酶联免疫吸附试验等方法有一定的诊断参考价值。 | [
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主要依靠流行病学特点及临床特征，遇有可疑病例必须仔细检查粪便、痰液的虫卵。 | [
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治疗首选吡喹酮75mg/kg，分3次口服，1日即可，具有效果好、疗程短、服用方便、副作用少等优点。 | [
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六、治疗疗程一般CAP抗感染治疗用至热退和主要呼吸道症状明显改善后3～7天。 | [
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而HAP治疗通常不少于10天，以免感染反复。 | [
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对于毒力强的病原或有并发症的难治性肺炎应适当延长疗程。 | [
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肺炎链球菌肺炎疗程7～10天；流感嗜血杆菌肺炎疗程14天左右；葡萄球菌肺炎尤其MRAS、MRSE疗程宜适当延长，平均28天；肠杆菌肺炎14～21天左右；铜绿假单胞菌等肺炎21～28天左右；支原体、衣原体或嗜肺军团菌肺炎需21天或更长；真菌性肺炎则需1～2个月。 | [
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第七节贫血的鉴别诊断一、概述引起小儿贫血的原因多种多样，种类繁多，且多数贫血最终有赖于详尽的实验室检查才能明确诊断。 | [
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以下将简述贫血的鉴别诊断。 | [
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（一）小细胞低色素性贫血（MCV、MCH、MCHC均＜正常低限）1.缺铁性贫血2.珠蛋白合成障碍性贫血3.铁粒幼细胞性贫血4.慢性感染5.铅中毒6.慢性失血7.缺铜性贫血8.严重营养不良（二）巨幼红细胞性贫血（MCV、MCH＞正常低限，MCHC正常）1.正常新生儿2.巨幼红细胞贫血（维生素B12</sub>或叶酸缺乏）3.再生障碍性贫血4.肝病5.切脾后6.多种原因所致红系造血代偿性增加7.阻塞性黄疸8.甲状腺功能减退（三）正细胞性贫血（MCV、MCH、MCHC均正常）1.急性失血2.急性再生障碍性贫血3.急性感染4.慢性肾炎、肾衰竭5.缺铁早期6.结缔组织病7.骨髓肿瘤细胞浸润8.恶性肿瘤全身播散9.肝脏病10.其他红系造血障碍（... | [
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第五节衣原体肺炎衣原体是一种细胞内寄生的微生物，含DNA和RNA。 | [
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有沙眼衣原体、肺炎衣原体和鹦鹉热衣原体三种，均可引起上呼吸道感染和肺炎。 | [
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一、沙眼衣原体肺炎沙眼衣原体肺炎（chlamydiatrachomatispneumonia）为沙眼衣原体（CT）引起。 | [
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多由受染的母亲传染或眼部感染经鼻泪管传入呼吸道。 | [
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},
{
"id": 2,
"entity": "呼吸道",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
... |
国内研究表明，CT占婴儿肺炎的18.4%。 | [
{
"id": 0,
"entity": "CT",
"start_offset": 7,
"end_offset": 9,
"label": "mic"
},
{
"id": 1,
"entity": "婴儿肺炎",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
}
] |
本病潜伏期2～3周，症状多在出生后3～12周出现，起病缓慢，先有鼻塞，然后出现咳嗽和气促，一般不发热。 | [
{
"id": 0,
"entity": "鼻塞",
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"end_offset": 34,
"label": "sym"
},
{
"id": 1,
"entity": "咳嗽",
"start_offset": 39,
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"label": "sym"
},
{
"id": 2,
"entity": "气促",
"start_offset": 42,
"end_offset": 44,
"label": "sym"
... |
胸部X线检查可表现为肺间质性病变、斑片状浸润和肺气肿。 | [
{
"id": 0,
"entity": "胸部X线",
"start_offset": 0,
"end_offset": 4,
"label": "ite"
},
{
"id": 1,
"entity": "肺间质性病变",
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"label": "sym"
},
{
"id": 2,
"entity": "斑片状浸润",
"start_offset": 17,
"end_offset": 22,
"label": "... |
血象中白细胞总数正常，50%～70%患儿可有轻、中度嗜酸性粒细胞增多。 | [
{
"id": 0,
"entity": "血象",
"start_offset": 0,
"end_offset": 2,
"label": "ite"
},
{
"id": 1,
"entity": "白细胞",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
},
{
"id": 2,
"entity": "嗜酸性粒细胞",
"start_offset": 26,
"end_offset": 32,
"label": "mic"
... |
血IgG、IgM和lgA可增高。 | [
{
"id": 0,
"entity": "血IgG",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
},
{
"id": 1,
"entity": "IgM",
"start_offset": 5,
"end_offset": 8,
"label": "mic"
},
{
"id": 2,
"entity": "lgA",
"start_offset": 9,
"end_offset": 12,
"label": "mic"
}... |
新生儿出生后3～12周发生肺炎、尤其是无热性肺炎者应考虑本病，并及时送鼻咽部分泌物或血标本作病原学检测。 | [
{
"id": 0,
"entity": "肺炎",
"start_offset": 13,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "无热性肺炎",
"start_offset": 19,
"end_offset": 24,
"label": "dis"
},
{
"id": 2,
"entity": "鼻咽部分泌物",
"start_offset": 35,
"end_offset": 41,
"label": "... |
【诊断】（一）目前诊断存在的问题抽动障碍的诊断目前仍以临床现象学诊断为主。 | [
{
"id": 0,
"entity": "抽动障碍",
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"end_offset": 20,
"label": "dis"
}
] |
这可以正确诊断抽动障碍和伴随的精神症状，有利于采取正确的治疗措施。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
}
] |
国际研究有采用脑部功能磁共振（fMRI）和正电子扫描（PET）为辅助诊断，并引用基因诊断技术的趋势。 | [
{
"id": 0,
"entity": "磁共振",
"start_offset": 11,
"end_offset": 14,
"label": "pro"
},
{
"id": 1,
"entity": "fMRI",
"start_offset": 15,
"end_offset": 19,
"label": "pro"
},
{
"id": 2,
"entity": "正电子扫描",
"start_offset": 21,
"end_offset": 26,
"label": "p... |
根据抽动病程的长短与病情的轻重，人为地将抽动障碍分为短暂性抽动障碍、慢性抽动障碍和TS三种类型，它们三者之间具有连续性，其中TS是病程在一年以上的运动性和发声性抽动兼有的较重病例。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 20,
"end_offset": 24,
"label": "dis"
},
{
"id": 1,
"entity": "短暂性抽动障碍",
"start_offset": 26,
"end_offset": 33,
"label": "dis"
},
{
"id": 2,
"entity": "慢性抽动障碍",
"start_offset": 34,
"end_offset": 40,
"label... |
由于抽动障碍的病因和发病机制迄今尚未明确，而各种检查包括神经系统软体征、脑电图（EEG）、诱发电位（EPs）、神经影像学检查（CT，MRI，SPECT，PET）、实验室检查和神经心理测验等，虽属客观指标，但这些检查仅在部分抽动障碍病人中发现有非特异性异常，只能作为诊断的辅助依据，目前尚未找到一种特异性的诊断手段来诊断本病。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "脑电图",
"start_offset": 36,
"end_offset": 39,
"label": "pro"
},
{
"id": 2,
"entity": "EEG",
"start_offset": 40,
"end_offset": 43,
"label": "pro"
... |
头颅CT或MRI等检查对抽动障碍的价值不在于诊断，而在于排除其他脑器质性病变。 | [
{
"id": 0,
"entity": "头颅CT",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "MRI",
"start_offset": 5,
"end_offset": 8,
"label": "pro"
},
{
"id": 2,
"entity": "抽动障碍",
"start_offset": 12,
"end_offset": 16,
"label": "dis"
... |
至于功能性磁共振成像（fMRI）、单光子发射计算机断层扫描（SPECT）、正电子发射扫描（PET）和经颅磁刺激（transcranialmagneticstimulation）等检查，能够用于抽动障碍脑功能研究。 | [
{
"id": 0,
"entity": "功能性磁共振成像",
"start_offset": 2,
"end_offset": 10,
"label": "pro"
},
{
"id": 1,
"entity": "fMRI",
"start_offset": 11,
"end_offset": 15,
"label": "pro"
},
{
"id": 2,
"entity": "单光子发射计算机断层扫描",
"start_offset": 17,
"end_offset": 29,
... |
在抽动障碍诊断方面，主要依据病人的临床表现（病史和临床症状）来进行诊断，国内外学者均采用临床描述性诊断方法来对抽动障碍进行诊断，并且必须排除风湿性舞蹈病、肝豆状核变性、癫痫肌阵挛性发作、药源性不自主抽动及其他锥体外系疾病。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 1,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "抽动障碍",
"start_offset": 55,
"end_offset": 59,
"label": "dis"
},
{
"id": 2,
"entity": "风湿性舞蹈病",
"start_offset": 70,
"end_offset": 76,
"label": "d... |
抽动障碍的诊断通常被延误多年，多数病人在症状出现几年以后才被诊断。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 0,
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"label": "dis"
}
] |
将喉肌抽动而致的干咳误诊为慢性咽炎、气管炎；将眨眼、皱眉诊为眼结膜炎；动鼻诊为慢性鼻炎等。 | [
{
"id": 0,
"entity": "喉肌抽动",
"start_offset": 1,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "慢性咽炎",
"start_offset": 13,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "气管炎",
"start_offset": 18,
"end_offset": 21,
"label": "dis"... |
（二）诊断标准1.短暂性抽动障碍（1）国际疾病分类第10版（ICD-10）关于暂时性抽动障碍的诊断标准：1）起病于儿童或青少年早期，以4～5岁儿童最常见。 | [
{
"id": 0,
"entity": "短暂性抽动障碍",
"start_offset": 9,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "暂时性抽动障碍",
"start_offset": 39,
"end_offset": 46,
"label": "dis"
}
] |
2）有复发性、不自主、重复、快速、无目的的单一或多部位运动抽动，或发声抽动，以眨眼、扮鬼脸或头部抽动较常见。 | [
{
"id": 0,
"entity": "运动抽动",
"start_offset": 27,
"end_offset": 31,
"label": "dis"
},
{
"id": 1,
"entity": "发声抽动",
"start_offset": 33,
"end_offset": 37,
"label": "dis"
},
{
"id": 2,
"entity": "眨眼",
"start_offset": 39,
"end_offset": 41,
"label": "sym... |
3）抽动能受意志克制短暂时间（数分钟至数小时），入睡后消失，检查未能发现神经系统障碍。 | [
{
"id": 0,
"entity": "神经系统障碍",
"start_offset": 36,
"end_offset": 42,
"label": "dis"
}
] |
4）抽动一天出现多次，几乎天天如此，至少持续2周，但病程不超过1年。 | [
{
"id": 0,
"entity": "抽动一天出现多次，几乎天天如此，至少持续2周，但病程不超过1年",
"start_offset": 2,
"end_offset": 33,
"label": "sym"
}
] |
5）排除风湿性舞蹈病、肝豆状核变性、癫痫肌阵挛发作、药源性不自主抽动和其他锥体外系病变。 | [
{
"id": 0,
"entity": "风湿性舞蹈病",
"start_offset": 4,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "肝豆状核变性",
"start_offset": 11,
"end_offset": 17,
"label": "dis"
},
{
"id": 2,
"entity": "癫痫肌阵挛发作",
"start_offset": 18,
"end_offset": 25,
"labe... |
（2）《美国精神疾病诊断与统计手册》第4版修订本（DSM-Ⅳ-TR）关于暂时性抽动障碍的诊断标准：1）一种或多种运动和或发声抽动。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 39,
"end_offset": 43,
"label": "dis"
}
] |
2）抽动一天发作多次，几乎每天发作持续时间至少4周，但不超过1年。 | [
{
"id": 0,
"entity": "抽动一天发作多次，几乎每天发作持续时间至少4周，但不超过1年",
"start_offset": 2,
"end_offset": 32,
"label": "sym"
}
] |
3）既往无慢性抽动障碍或TS病史。 | [
{
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"entity": "抽动障碍",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "TS",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
}
] |
5）抽动障碍症状不是直接由某些药物（如兴奋剂）或内科疾病（如亨廷顿舞蹈病或病毒感染后脑炎）所致。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "兴奋剂",
"start_offset": 19,
"end_offset": 22,
"label": "dru"
},
{
"id": 2,
"entity": "亨廷顿舞蹈病",
"start_offset": 30,
"end_offset": 36,
"label": "di... |
（3）《中国精神障碍与诊断标准》第3版（CCMD-3）关于短暂性抽动障碍的诊断标准：1）有单个或多个运动性抽动或发声抽动，常表现为眨眼、扮鬼脸或头部抽动等简单抽动。 | [
{
"id": 0,
"entity": "短暂性抽动障碍",
"start_offset": 29,
"end_offset": 36,
"label": "dis"
},
{
"id": 1,
"entity": "眨眼",
"start_offset": 65,
"end_offset": 67,
"label": "sym"
},
{
"id": 2,
"entity": "扮鬼脸",
"start_offset": 68,
"end_offset": 71,
"label": "s... |
4）不是由于TS、小舞蹈病、药物或神经系统其他疾病所致。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "小舞蹈病",
"start_offset": 9,
"end_offset": 13,
"label": "dis"
}
] |
2.慢性抽动障碍（1）ICD-10关于慢性抽动障碍的诊断标准：1）有反复性、不自主、重复、快速、无目的的抽动，任何一次抽动不超过三组肌肉。 | [
{
"id": 0,
"entity": "慢性抽动障碍",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "慢性抽动障碍",
"start_offset": 19,
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"label": "dis"
},
{
"id": 2,
"entity": "反复性、不自主、重复、快速、无目的的抽动",
"start_offset": 34,
"end_offset": 5... |
7）排除慢性锥体外系病变、癫痫肌阵挛发作、面肌痉挛和精神病装相等。 | [
{
"id": 0,
"entity": "慢性锥体外系病变",
"start_offset": 4,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "癫痫肌阵挛发作",
"start_offset": 13,
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"label": "dis"
},
{
"id": 2,
"entity": "面肌痉挛",
"start_offset": 21,
"end_offset": 25,
"labe... |
（2）DSM-Ⅳ-TR关于慢性抽动障碍的诊断标准：1）一种或多种运动或发声抽动，但在病程中不同时出现。 | [
{
"id": 0,
"entity": "慢性抽动障碍",
"start_offset": 13,
"end_offset": 19,
"label": "dis"
}
] |
4）抽动障碍症状不是由某些药物（如兴奋剂）或内科疾病（如亨廷顿舞蹈病或病毒感染后脑炎）所致。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "兴奋剂",
"start_offset": 17,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "亨廷顿舞蹈病",
"start_offset": 28,
"end_offset": 34,
"label": "di... |
（3）CCMD-3关于慢性抽动障碍的诊断标准：1）不自主运动抽动或发声，可以不同时存在，常1天发生多次，可每天或间断出现。 | [
{
"id": 0,
"entity": "慢性抽动障碍",
"start_offset": 11,
"end_offset": 17,
"label": "dis"
}
] |
4）不是由于TS、小舞蹈病、药物或神经系统其他疾病所致。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "小舞蹈病",
"start_offset": 9,
"end_offset": 13,
"label": "dis"
}
] |
3.TS通常推荐TS“必须诊断标准（essentialdiagnosticcriteria）”，包括：21岁以前发病，多发性不自主的运动抽动，一种或多种发声抽动，有一加重或减轻的病程，新的症状逐渐代替旧的症状，抽动缺乏其他医学解释和病程超过1年。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
}
] |
发声抽动对TS的诊断是必须的，但需要强调的是，本病的诊断标准中秽语不是必须的，因为秽语只发生在不到13病例中。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 5,
"end_offset": 7,
"label": "dis"
}
] |
（1）ICD-10关于TS的诊断标准：1）起病于21岁以前，大多数在2～15岁之间。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
}
] |
2）有复发性、不自主、重复的、快速的、无目的的抽动，影响多组肌肉。 | [
{
"id": 0,
"entity": "复发性、不自主、重复的、快速的、无目的的抽动，影响多组肌肉",
"start_offset": 3,
"end_offset": 32,
"label": "sym"
}
] |
3）多种运动抽动和一种或多种发声抽动同时出现于某些时候，但不一定必须同时存在。 | [
{
"id": 0,
"entity": "多种运动抽动",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
}
] |
6）抽动一天发作多次，几乎天天如此；病程超过1年以上，且在同一年之中症状缓解不超过2个月以上。 | [
{
"id": 0,
"entity": "抽动一天发作多次",
"start_offset": 2,
"end_offset": 10,
"label": "dis"
}
] |
7）排除风湿性舞蹈病、肝豆状核变性、癫痫肌阵挛发作、药源性不自主抽动和其他锥体外系病变。 | [
{
"id": 0,
"entity": "风湿性舞蹈病",
"start_offset": 4,
"end_offset": 10,
"label": "dru"
},
{
"id": 1,
"entity": "肝豆状核变性",
"start_offset": 11,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "癫痫肌阵挛发作",
"start_offset": 18,
"end_offset": 25,
"labe... |
（2）DSM-Ⅳ-TR关于TS的诊断标准：1）在病程中具有多种运动抽动及一种或多种发声抽动，而不必在同一时间出现。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 13,
"end_offset": 15,
"label": "dru"
}
] |
2）抽动可每天发作多次（通常为丛集性）或间歇发作，但间歇时间不超过3个月，抽动病程在1年以上。 | [
{
"id": 0,
"entity": "抽动可每天发作多次（通常为丛集性）或间歇发作",
"start_offset": 2,
"end_offset": 24,
"label": "sym"
}
] |
5）抽动障碍症状不是直接由某些药物（如兴奋剂）或内科疾病（如亨廷顿舞蹈病或病毒感染后脑炎）所致。 | [
{
"id": 0,
"entity": "抽动障碍",
"start_offset": 2,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "兴奋剂",
"start_offset": 19,
"end_offset": 22,
"label": "dru"
},
{
"id": 2,
"entity": "内科",
"start_offset": 24,
"end_offset": 26,
"label": "dep"
... |
（3）CCMD-3关于TS的诊断标准：TS是以进行性发展的多部位运动和发声抽动为特征的抽动障碍，部分患儿伴有模仿言语、模仿动作，或强迫、攻击、情绪障碍，及注意缺陷等行为障碍，起病于童年。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 11,
"end_offset": 13,
"label": "dis"
},
{
"id": 1,
"entity": "TS",
"start_offset": 19,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "抽动障碍",
"start_offset": 43,
"end_offset": 47,
"label": "dis"
... |
1）症状标准：表现为多种运动抽动和一种或多种发声抽动，多为复杂性抽动，二者多同时出现。 | [
{
"id": 0,
"entity": "多种运动抽动",
"start_offset": 10,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "一种或多种发声抽动",
"start_offset": 17,
"end_offset": 26,
"label": "dis"
},
{
"id": 2,
"entity": "复杂性抽动",
"start_offset": 29,
"end_offset": 34,
"la... |
此外，难治性TS是近些年来小儿神经精神科临床逐渐形成的新概念，用于描述经过常规药物（氟哌啶醇及硫必利等）治疗效果不好，病程迁延不愈的TS病人。 | [
{
"id": 0,
"entity": "TS",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "氟哌啶醇",
"start_offset": 42,
"end_offset": 46,
"label": "dru"
},
{
"id": 2,
"entity": "硫必利",
"start_offset": 47,
"end_offset": 50,
"label": "dru"
... |
难治性Tourette综合征（intractableTourettesyndrome）的诊断标准：①符合ICD-10中TS的诊断标准，排除风湿性舞蹈病、肝豆状核变性、习惯性痉挛和癫痫；②YGTSS得分≥50；③经氟哌啶醇或和硫必利足量治疗1年以上无效。 | [
{
"id": 0,
"entity": "Tourette综合征",
"start_offset": 3,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "intractableTourettesyndrome",
"start_offset": 15,
"end_offset": 42,
"label": "dis"
},
{
"id": 2,
"entity": "TS",
"start_offset": 59,
"end_o... |
三、新生儿免疫性血小板减少性紫癜在孕期中母亲的一部分抗体可通过胎盘进入胎儿体内，如果这部分抗体可引起血小板减少，则新生儿可出现血小板减少性紫癜。 | [
{
"id": 0,
"entity": "新生儿免疫性血小板减少性紫癜",
"start_offset": 2,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "抗体",
"start_offset": 26,
"end_offset": 28,
"label": "bod"
},
{
"id": 2,
"entity": "血小板",
"start_offset": 50,
"end_offset": 53,
"labe... |
广义的新生儿免疫性血小板减少性紫癜主要包括药物、新生儿ITP（NITP）、新生儿同种免疫性血小板减少性紫癜（neonatalalloimmunethrombocytopenicpurpura，NAIT）。 | [
{
"id": 0,
"entity": "新生儿免疫性血小板减少性紫癜",
"start_offset": 3,
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"label": "dis"
},
{
"id": 1,
"entity": "新生儿ITP",
"start_offset": 24,
"end_offset": 30,
"label": "dis"
},
{
"id": 2,
"entity": "NITP",
"start_offset": 31,
"end_offset": 35,
... |
1.NITP患有ITP孕母的抗血小板抗体可通过胎盘进入胎儿体内，破坏胎儿的血小板。 | [
{
"id": 0,
"entity": "NITP",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "ITP",
"start_offset": 8,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "抗血小板抗体",
"start_offset": 14,
"end_offset": 20,
"label": "bod... |
不论患ITP孕母在孕期或分娩时有否血小板减少，约50%的新生儿可能出现血小板减少。 | [
{
"id": 0,
"entity": "ITP",
"start_offset": 3,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 17,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "血小板",
"start_offset": 35,
"end_offset": 38,
"label": "bod"
... |
在产前首先要分析孕妇状况对胎儿的影响，如孕母有否血小板降低及其减低程度，是否已切脾，是否分娩过血小板减少的新生儿。 | [
{
"id": 0,
"entity": "血小板",
"start_offset": 24,
"end_offset": 27,
"label": "bod"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 47,
"end_offset": 50,
"label": "bod"
}
] |
如果怀疑胎儿有血小板降低，有条件者可作经皮脐静脉采样测血小板数，当胎儿血小板＜50×109</sup>/L时，母亲可试用静脉丙种球蛋白1g/（kg•d）；如孕期已有足够长，必要时亦可进行剖宫产。 | [
{
"id": 0,
"entity": "血小板",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 1,
"entity": "皮脐静脉采样",
"start_offset": 20,
"end_offset": 26,
"label": "pro"
},
{
"id": 2,
"entity": "血小板数",
"start_offset": 27,
"end_offset": 31,
"label": "i... |
产后的NITP处理原则基本同ITP，需要同新生儿科医师合作进行。 | [
{
"id": 0,
"entity": "NITP",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "ITP",
"start_offset": 14,
"end_offset": 17,
"label": "dis"
}
] |
2.NAIT发病机制与新生儿溶血相似，胎儿由父亲遗传获得不同于母亲的血小板抗原，通过胎盘进入母体刺激产生相应IgG抗体，该抗体在通过胎盘进入胎儿血循环并破坏其血小板。 | [
{
"id": 0,
"entity": "NAIT",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "抗体",
"start_offset": 61,
"end_offset": 63,
"label": "bod"
},
{
"id": 2,
"entity": "胎盘",
"start_offset": 66,
"end_offset": 68,
"label": "bod"
... |
产后可于数分钟或数小时内发病，症状同血小板减少性紫癜，但常较重；颅内出血可发生于产前或产后，是常见的死因。 | [
{
"id": 0,
"entity": "血小板减少性紫癜",
"start_offset": 18,
"end_offset": 26,
"label": "dis"
}
] |
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