传染性单核细胞增多症临床误诊分析

Misdiagnosis Analysis of Infectious Mononucleosis

目的 探讨传染性单核细胞增多症（ 传单） 误诊的原因。方法 对具有发热、咽峡炎、淋巴结肿大、肝脾肿大的患儿２０ 例作了外周血象分析，１５ 例作了血清嗜异体凝集试验。结果 外周血象分析２０ 例，经反复检测，血淋巴细胞大于０ ．６０ 的１８ 例，并出现异形淋巴细胞，异形淋巴细胞大于０ ．１０ 的１６ 例，偶见２ 例。血嗜异凝集试验检查１５ 例，凝集价在１ ：５６ 以上者１０ 例。结论 传单特征性的表现是外周血中异常淋巴细胞增多（０ ．１０ ～０ ．６０） 对疑似本病者应反复检查外周血象。血清嗜异体凝集试验凝集价在１ ：５６ 以上是可靠的诊断指标。对具有发热、咽峡炎、淋巴结肿大、肝脾肿大的患儿具有以上任何一项即可确诊。

Objective To probe into the reason for misdiagnosis of infectious mononucleosis. Methods Pripheral blood analysis was done in all 20 cases with fever, angina, enlarged lymph nodes and enlargement of liver and spleen. Heterophil agglutination test was done in 15 of these 20 cases.Results There were 18 cases whose lymphocyte ratio was above 0.60 with abnormal lymphocytes above 0.10 in 16 cases.In other 2 cases,abnormal lymphocytes were occasionally seen.In 10 case of 15,agglutination titer was above 1:56.Conclusion The characteristic manifestation of infectious mononucleosis is the increasing of abnormal lymphocytes in peripheral blood. So we should do blood analysis repeatedly in those suspicious of infectious mononuclcosis . Agglutination titer more than 1: 56 is reliable to diagnose infectious mononucleosis.