儿童EB病毒相关传染性单核细胞增多症108例临床分析

Clinical analysis of 108 children suffering from EB virus-associated infectious mononucleosis

目的观察108例不同年龄儿童EB病毒(EBV)感染相关传染性单核细胞增多症(IM)的临床特征。方法收集2012年9月至2014年9月深圳市宝安区中心医院儿科收治的108例确诊为EB病毒相关传染性单核细胞增多症患儿的临床资料,进行回顾性分析,按年龄将患儿分为<7岁组(n=51)和≥7岁(n=57)组,比较两组的临床症状、体征及实验室检查结果。结果发热、咽峡炎、淋巴结大及眼睑水肿的发生率分别为87.9%、86.1%、86.1%、90.7%,肝大、脾大及皮疹的发生率分别为40.7%、43.5%、13.9%。<7岁组患儿肝大、脾大的发生率以及外周血白细胞(WBC)计数高于≥7岁组(P<0.05),≥7岁组谷丙转氨酶(ALT)和谷草转氨酶(AST)高于<7岁组儿童;差异有统计学意义(P<0.05)。结论不同年龄段儿童EBV感染IM的临床症状、体征及实验室检查存在差异。<7岁组儿童肝脾大的发生率较高,WBC计数较高;而≥7岁组儿童转氨酶升高的程度更重,肝损害的发生率更高。

Objective To investigate clinical characteristics of Eepstein-Barr virus（EBV）-associated infectious mononucleosis in 108 children of different ages. Methods By collecting clinical data,a retrospective study was conducted in 108 cases of EBV-associated infectious mononucleosis syndrome who were enrolled from September 2012 to September 2014 in the pediatric of Baoan Central Hospital of Shenzhen. Patients were divided by age into 7 years old group and ≥7years old group;clinical symptoms and signs,and laboratory test results were compared between the two groups. Results The Incidence of fever,angina,lymph nodes and eyelid edema were 87.9%,86.1%,86.1%,90.7%,respectively.The incidence of hepatomegaly,splenomegaly and skin rash respectively were 40.7%,43.5%,and 13.9%. The incidence of hepatomegaly and splenomegaly in 7 years old was significantly higher than that of ≥7 years old group（P0.05）. Peripheral white blood cell（WBC） count of 7 years old children was higher than that of ≥7 year old group（P0.05）. The values of alanine aminotransferase（ALT） and aspartate aminotransferase（AST） in ≥7 years old were greater than those 7 years old group（P0.05）. ConclusionsMononucleosis clinical symptoms,signs and laboratory tests are different in children of different ages with EBV-associated infectious mononucleosis. The incidence of hepatomegaly and splenomegaly and peripheral WBC count were higher in patients of 7 years old group than those of ≥7 year old group;and patients of ≥7 years old group had heavier elevated transaminase and higher incidence of liver damage than those of 7 years old group.