儿童非典型EB病毒感染的临床回顾分析

Clinical review and analysis of atypical Epstein-Barr virus infection in children

目的探讨儿童非典型EB病毒(EBV)感染的临床特点。方法2000年3月至2005年4月,深圳市儿童医院在住院患儿中检测出EBVVCAIgM和(或)EBVDNA阳性共690例,其中传染性单核细胞增多症422例,另外268例为非典型EBV感染,对其临床特点进行回顾性分析。结果儿童非典型EBV感染以呼吸道感染最为多见(191/268,71.3%),其它为皮炎13例(4.9%)、腹泻病10例(3.7%)、血小板减少性紫癜10例(3.7%)、肾炎或肾病7例(2.6%)、肠系膜或颈淋巴结炎8例(3.0%)、结膜炎7例(2.6%),川崎病、嗜血细胞综合征、中枢神经系统感染各4例(1.5%),心肌炎、播散性脑脊髓炎各2例(0.7%),再生障碍性贫血、坏死性淋巴结炎、腮腺炎、高IgM血症、嗜酸细胞增多症各1例(0.4%),诊断不明1例(0.4%)。其中嗜血细胞综合征患儿有2例死亡。结论儿童非典型EBV感染症状多样,累及系统多,预后不一。EBVVCAIgM或EBVDNA检测有利于早期诊断,并进行合理治疗。

Objective To evaluate the clinical features of atypical Epstein-Barr virus infection in children. Methods From 2000/03/01 to 2005/04/30, the detection of EBV-VCA-IgM and/or EBV-DNA was positive in 690 hospitalized children ;422 were diagnosed infectious mononucleosis;retrospective analysis was made in the other 268 with atypical EBV infection. Results In 268 atypical EBV infection,respiratory tract infection was 191 ,dermitis 13,diarrhea disease 10,idiopathic thrombcytopenia 10, nephritis or nephropathia 7, adenomesenteritis or deradenitis 8, ophthalmia 7, Kawasaki disease 4, hemophagocytic syndrome 4, central nerve system infection 4, myoearditis 2, desseminate encephalomyelitis 2, aplastic anemia 1 ,necrotizing lymphademitis 1 ,parotitis 1, hyper-IgM syndrome 1 and acidocytosis 1. One case was not diagnosed. 2 died of hemophagocytic syndrome, Conclusion The systems and organs impaired by atypical EBV infection in children are diverse. The prognosis was different. Detection of EBV-VCA-IgM or EBV-DNA is beneficial to early diagnosis and proper treatment.