EB病毒和巨细胞病毒双重感染的传染性单核细胞增多症的临床特征

Characteristics of infectious mononucleosis with dual infection of Epstein-Barr virus and cytomegalovirus

目的 探讨EB病毒（EBV）和巨细胞病毒（CMV）双重感染的传染性单核细胞增多症（IM）的临床特征.方法 回顾性总结21例由EBV和CMV双重感染导致IM的临床特点,并与单独EBV感染导致的IM病例进行比较.结果 ①两组间临床特点比较：双重感染组的发热持续时间显著长于EBV感染组（P＜0.01）,双重感染组的肝肿大发生率和脾肿大发生率均显著高于EBV感染组（分别P＜0.05,P＜0.01）.IM并发症,如血小板减少症、肺炎和贫血的发生率在双重感染组均显著高于EBV感染组（P＜0.01）.②各组间实验室指标比较：异型淋巴细胞百分比和肝功能异常的发生率在双重感染组均显著高于EBV感染组（P＜0.01）.结论 EBV和CMV双重感染IM常临床症状较重,发热持续时间较长,并发症如血小板减少症、肺炎和贫血的发生率较高.

Objective The aim of this study was to explore the characteristics of infectious mononucleosis with dual infection of Epstein-Barr virus and cytomegalovirus.Method The characteristics of 21 children with IM infected by EBV/CMV were retrospectively analyzed and compared with the EBV infection cases.Results ① Clinical manifestations：the duration of fever was significantly higher in the EBV/CMV dual infection group than that in the EBV infection group （P 〈 0.05）.The incidence of hepatomegaly and splenomegaly were significantly higher in the dual infection group than that in the EBV infection group （P 〈 0.05 or P 〈 0.01）.A significantly higher frequency of complicating thrombocytopenia,pneumonia and anemia were observed in the EBV/CMV dual infection group than in the EBV infection group （P 〈 0.01）.②Laboratory findings：the rate of atypical lymphocyte and the incidence of abnormal liver function were significantly higher in the dual infection group than that in the EBV infection group （P 〈 0.01）.Conclusion The IM cases with EBV/CMV dual infection often manifest as more severe symptoms who show a much longer febrile period and a higher incidence of complications,including thrombocytopenia,pneumonia and anemia,compared with single EBV infection.