儿童传染性单核细胞增多症110例临床分析

Clinical analysis of 110 cases of infectious mononucleosis in children

目的分析儿童传染性单核细胞增多症临床特点。方法回顾性分析2015年1月-2018年1月收住的110例传染性单核细胞增多症患儿临床资料,总结并分析其临床特点。结果 110例患儿中男74例(67.3%)、女36例(32.7%),男女之比2.1∶1;年龄分别为2～<3岁29例(26.4%)、3～6岁67例(60.9%)、>6～13岁14例(12.7%);症状表现有发热101例(91.8%)、咽峡炎100例(90.9%)、淋巴结肿大95例(86.4%)、眼睑浮肿79例(71.8%)、脾脏肿大55例(50.0%)、肝脏肿大37例(33.6%);病程中合并肺炎61例(55.5%)、心肌损害53例(48.2%)、中性粒细胞减少35例(31.8%)、血小板减少性紫癜4例(3.6%);EB病毒指标检测结果:衣壳抗原IgG抗体阳性率88.2%、衣壳抗原IgM抗体阳性率43.6%,早期抗原IgM抗体阳性率31.8%,核抗原IgG抗体阳性率56.4%;外周血异型淋巴细胞阳性率46.4%。结论儿童传染性单核细胞增多症多发于男性且以3～6岁常见,临床症状表现多样,肺炎以及心肌损害为主要合并症,EB病毒指标检测与血清学检测有助于诊断工作。

Objective To analyze the clinical characteristics of 110 cases of infectious mononucleosis in children. Methods The clinical data of 110 children with infectious mononucleosis in the period from January 2015 to January 2018 were analyzed retrospectively. Results The 110 patients included 74 males(67.3%) and 36 females(32.7%). The male to female ratio was 2.1∶1.The age distribution: 2~<3 years old, 29 cases(26.4%);3-6 years old, 67 cases(60.9%);>6-13 years old, 14 cases(12.7%).The main symptoms and signs included fever in 101 cases(91.8%), pharyngitis in 100 cases(90.9%), lymphadenomegaly in 95 cases(86.4%), eyelid edema in 79 cases(71.8%), splenomegaly in 55 cases(50.0%), and liver enlargement in 37 cases(33.6%).The complications were pneumonia in 61 cases(55.5%), myocardial damage in 53 cases(48.2%), neutropenia in 35 cases(31.8%),and thrombocytopenic purpura in 4 cases(3.6%). The prevalence of IgM antibody against Epstein-Barr virus capsid antigen was43.6%. The prevalence of IgM antibody against Epstein-Barr virus early antigen was 31.8%. The positive rate of IgG antibody against Epstein-Barr virus nuclear antigen was 56.4%. The prevalence of atypical lymphocytes in peripheral blood was 46.4%.Conclusions Infectious mononucleosis in children is more common in males and during the period from 3 to 6 years of age. The clinical symptoms include pneumonia and myocardial damage. Epstein-Barr virus detection and serological assay are helpful for diagnosis.