不同年龄儿童传染性单核细胞增多症临床特点分析

Analysis of clinical features of infectious mononucleosis with different age children

目的探讨儿童传染性单核细胞增多症(infectious mononucleosis,IM)的临床特点与发病年龄的关系。方法 2009年1月—2013年12月268例IM住院患儿按年龄分期分为4组:婴儿组(≤1岁)、幼儿组(≤3岁)、学龄前组(≤6岁)和学龄组(>6岁),进行回顾性分析。结果发病高峰为学龄前期,幼儿期也占相当的比例。高热、淋巴结炎、扁桃体渗出、眼睑水肿在年长儿多见,而皮疹在小年龄患儿多见,差异有统计学意义(P<0.05)。肝肿大幼儿组较学龄前组及婴儿组低,差异有统计学意义(P<0.05)。脾肿大、肝功能损害及血小板减少各年龄组间差异无统计学意义(P>0.05)。小年龄组患儿更易出现贫血与心肌损害,差异有统计学意义(P<0.05)。异常淋巴细胞比例随年龄增加而增高。除婴儿期外,随年龄增加,CD4^+T细胞降低,CD8^+T细胞增加。结论儿童IM某些临床特点与发病年龄有关,应予以重视,以提高确诊率。

Objective To investigate clinical characteristics of infectious mononucleosis （IM） in children and their relation with the onset ages. Methods From January 2009 to December 2013, 268 cases of IM children by age stages were divided into 4 groups： baby group （≤1 year old）, children＇s group （≤3 years old）, preschool group （≤6 years old）, and school age group （ 〉 6 years old）, and were retrospectively analyzed. Results The onset peak was for preschool, and early childhood also accounted for considerable proportion. Fever, lymphnoditis, tonsil effusion, and eyelid edema were found mainly in the older children, and skin rashes were found mainly in younger children with statistical signifieanees （P 〈 0. 05 ）. Hepatomegaly rate of children＇s group was lower than those of preschool and baby groups, and the difference was statistically significant （P 〈0. 05 ）. There were no statistical signifieanees in splenomegaly, thrombocytopenia, and liver function damage rates among all age groups （ P 〉 0. 05 ）. Anemia and myocardial damage occurred mainly in younger children, and the differences were statistically significant （ P 〈 0. 05 ）. Abnormal lymphocyte ratio increased with the increase of age. Except baby group, along with the age increasing, CD4 ^＋ T ceils decreased and CD8 ^＋T cells increased in other groups. Conclusion The clinical features of childhood IM are associated with the age, which needs to be taken into consideration in order to improve the diagnosis of IM.