儿童传染性单核细胞增多症49例临床分析

Clinical Characteristics of 49 Children with Infectious Mononucleosis

目的:分析儿童传染性单核细胞增多症(简称传单)的临床特点。方法:回顾性分析本院儿科2004年6月至2006年5月诊治的儿童传单49例的临床资料。结果:传单临床表现多样,除发热,咽峡炎,颈淋巴结肿大常见外,肝肿大(82%),鼻塞(49%)和双眼睑水肿(29%)较多见;传单肝功改变以酶学改变为主,其中以乳酸脱氢酶升高最常见,各年龄组传单患儿外周血异型淋巴细胞均明显升高;早期检测EBV-IgM总体阳性率为86%,发生EBV相关性噬血细胞综合征1例。结论:传染性单核细胞增多症是累及多系统的全身性疾病,临床表现多样,易误诊,需提高对本病的认识以早期诊断。

Objective： To analyze the clinical feature of children with infectious mononucleosis（IM）. Methods： The data of 49 cases of children with IM admitted from June, 2004 to May, 2006 were analyzed retrospectively. Results： Except the most common manifestation of fever, sore throat and cervical lymphadenopathy, hepatosplenomegaly （82）, eyelids edema （49%）,nasal obstruction（29%） were not unusual. The liver injury of IM was mainly elevated enzymes especially lactic dehydrogenase. The number of atypical lymphocyte （AL） in peripheral blood was statistically higher than normal level. The total positive rate of anti-Epstein-Barr virus VCA-IgM was 86%. One case was complicated with EBV associated hemophagocytosis. Conclusion： IM is a systematic disease with varied clinical feature, which can be easily mislead, we must gain the knowledge of the disease to make the earlier diagnosis.