重症传染性单核细胞增多症危险因素分析

An Analysis of Risk Factors of Severe Infectious Mononucleosis

目的探讨重症传染性单核细胞增多症(infectious mononucleosis,IM)的临床特点及危险因素。方法回顾性分析346例住院IM患儿的临床资料,对305例普通IM和21例重症IM的病例进行组间对照研究,重症IM发生的危险因素采用Logistic回归分析。结果单因素Logistic回归分析显示,高热(>40℃)、黄疸、血象中2～3系降低、心肌损害、EBV DNA载量大于5.0×106copise/mL与重症IM有关(p<0.05或p<0.01),对上述5个因素进一步作逐步Logistic回归分析发现,黄疸、EBV DNA载量大于5.0×106copise/mL与重症IM有关(p<0.05或p<0.01),回归方程Logit(P)=-3.545+1.892x1+3.039x2,方程敏感性57.1%、特异性85.8%。结论 EBV DNA载量大于5.0×106copies/mL和黄疸可能与重症IM发生有关。

Objective To explore the clinical characteristics and risk factors of severe infectious mononucleosis（IM）.Method The clinical materials of 346 inpatients with IM received a retrospective analysis.A comparison was made between 305 common cases with IM and 21 cases with severe IM,and the risk factors of severe IM received Logistic regression analysis.Results Single-factor logistic regression analysis indicated that the items including hyperpyrexia（40℃）,jaundice,the decreases in line two and line three hemogram,cardiac damage and the EBV DNA load（5.0×106copise/mL） were related to severe IM（p0.05 or p0.01）.And the further Logistic regression analysis of these five factors showed that jaundice and the EBV DNA load（5.0×106copise/mL） were relevant to severe IM（p0.05 or p0.01）.The regression equation is Logit（P）=-3.545＋1.892x1＋3.039x2,and its sensitivity was 57.1% and specificity 85.8%.Conclusion The EBV DNA load（5.0×106copies/mL） and jaundice may be responsible for the occurrence of severe IM.