儿童传染性单核细胞增多症118例临床分析

Clinical analysis of 118 children with infectious mononucleosis

目的分析儿童传染性单核细胞增多症的临床症状和体征及实验室检验结果 ,帮助提高诊疗水平。方法回顾性分析2014年7月~2016年6月入院的118例IM患儿的临床资料。结果研究发现本组患儿中1~8岁患病最多,共95例(80.5%);除1例疑似EB病毒相关性嗜血综合征病例,其余大多预后良好。临床症状以三联征包括发热(98.3%)、咽峡炎(78.0%)、颈淋巴结肿大(72.9%)最常见,肝脏肿大者占55.9%,脾脏肿大占48.3%,皮疹占36.4%,打鼾和眼睑浮肿占52.5%。实验室检查:112例白细胞(WBC)计数>10×10~9/L(94.9%),淋巴细胞比例>35%的患者有108例(91.5%),>50%的有86例(72.9%),异型淋巴细胞比例>10%者占70.3%,谷丙转氨酶升高者占58.5%,EB病毒(EBV)的IgM抗体(EBV-CA-IgM)阳性率66.1%。结论儿童传染性单核细胞增多症可造成多系统功能损害,临床表现复杂,可结合实验检验结果对IM有更全面的认识。

Objective To analyze the clinical symptoms, signs and laboratory test results of infectious mononucleosis （IM） in children and to improve the level of diagnosis and treatment. Methods The clinical data of 118 children with IM who were admitted to our hospital from July 2014 to June 2016 were retrospectively analyzed. Results The study found that the children patients with 1 to 8 years old were the most in the group, with a total of 95 cases（80.5%）; in addition to one case of suspected EBV-assoeiated bloodthirsty syndrome, most of the other children had a good prognosis. Clinical symptoms were mostly seen in triple syndromes including fever（98.3%）, angina（78.0%）, and cervical lymphadenopathy （72.9%）. Liver enlargement accounted for 55.9%, spleen enlargement accounted for 48.3%, rash accounted for 36.4%, snoring and eyelid edema accounted for 52.5%. Laboratory examination： 112 cases of white blood cells （WBC） count〉10×10^9/L（94.9%）. There were 108 cases （91.5%） with the proportion of lymphocyte〉 35%, and 86 cases （72.9%） with the proportion 〉50%. The cases with the proportion of abnormal lymphocyte 〉10% accounted for 70.3%. The cases with increased alanine aminotransferase accounted for 58.5%. The positive rate of IgM antibody（EB virus capsid antigen IgM, EBV-CA-IgM） of EB virus （Epstein-Barr virus） was 66.1%. Conclusion Infectious mononucleosis in children can cause multiple system dysfunction, with complex clinical manifestations, which can be comprehensively understood via experiment test results.