小儿传染性单核细胞增多症的临床与实验室检查特点分析

Analysis of the Characteristics of Clinic and Laboratory Examination in Children with Infectious Mononucleosis

【目的】探讨传染性单核细胞增多症的临床症状、体征、器官损害和实验室检查特点，有利于减少临床漏诊与误诊。【方法】对本院儿科传染性单核细胞增多症临床资料进行回顾性分析。【结果】3～7岁发病53．1％，临床以发热（90．8％）、颈淋巴结炎（91．8％）、咽峡炎（87．8％）、肝脏肿大（68．4％）、脾脏肿大（60．2％）为主要表现。肝功能损害是最常见的并发症。病程中异型淋巴细胞比例增高程度和EB病毒VCA-IgM阳性与否与疾病的病情程度及并发症发生无明显关系；发病年龄是重要的高危因素，发病年龄越大，血小板计数降低，肝功能损害和心肌酶异常更明显。【结论】大多数传染性单核细胞增多症呈良性临床经过，多具有较典型的临床表现，但并发症常见且多样，可累及多种器官，应予重视。

[Objective]To explore the clinical symptoms, signs, damages to organs and system and the characteristics of laboratory tests and to reduce missed diagnosis and misdiagnosis. [Methods]Retrospective analysis was performed on the clinical data from patients diagnosed as infectious mononucleosis（IM） in department of pediatrics. [Results]The rate of onset from 3 years old to 7 years old was 53. 1%. The main clinical appearances were fever （ 90. 8 % ）, lymphadenopathy of neck （ 91.8 % ）, pharyngitis （ 87.8 % ）, hepatomegaly （68.4%）, and splenomegaly（60. 2%）. The ratio of atypical lymphocyte and EB virus capsid antibody-IgM positive or negative had nothing to do with pathogenetic condition and complication. The age of onset was the major high risk factor. There was positive correlation to the decrease of platelet count, the damage to hepatic function and the dysfunction of cardiac kinase. [conclusion]The clinical progress of most infectious mononucleosis is benign, with typical clinical manifestations, but complications are common and multiple and many organs can be involved. So IM should be paid attention to.