EB病毒感染与巨细胞病毒感染的传染性单核细胞增多症患儿临床表现和实验室检查差异

Clinical Manifestations and Laboratory Examination of Infectious Mononucleosis in Children with Epstein Barr Virus Infection and Cytomegalovirus Infection

目的:比较EB病毒(EBV)感染与巨细胞病毒(CMV)感染的传染性单核细胞增多症(IM)患儿临床表现和实验室检查差异。方法:回顾性分析本院2016年9月至2019年3月35例EBV感染(EBV组)与40例CMV感染(CMV组)引起IM患儿的临床资料,比较两组患儿主要临床表现和实验室检查指标的差异。结果:两组患儿发热、淋巴结肿大、脾脏肿大、肝脏肿大、眼睑浮肿、皮疹发生率的比较,均无明显差异(P>0.05),但EBV组咽峡炎发生率较CMV组明显升高(P<0.05)。两组患儿以淋巴结肿大、咳嗽、发热、咽峡炎、眼睑水肿和喘息为首发症状的比例比较,均无明显差异(P>0.05),但EBV组以鼻塞/流涕为首发症状的比例较CMV组明显升高(P<0.05)。两组患儿红细胞(RBC)、白细胞(WBC)、淋巴细胞和中性粒细胞数比较,均无明显差异(P>0.05),但EBV组血小板(PLT)、谷丙转氨酶(ALT)和异型淋巴细胞(A-lym)数较CMV组均明显升高(P<0.05)。结论:EBV感染与CMV感染引起的IM患儿首发症状均以发热为多见,但相比CMV感染患儿,EBV感染患儿以鼻塞/流涕为首发症状的发生率较高,血小板、谷丙转氨酶和异型淋巴细胞升高程度较高,肝功能损害程度较重。

Objective: To compare the clinical manifestations and laboratory examinations of children with infectious mononucleosis(IM) infected by EB virus(EBV) and cytomegalovirus(CMV). Methods: The clinical data of 35 children with IM caused by EBV infection(EBV group) and 40 children with CMV infection(CMV group) in our hospital from September 2016 to March 2019 were retrospectively analyzed. The main clinical manifestations and laboratory examination indexes of the two groups were compared. Results: There was no significant difference in the incidence of fever, lymph node enlargement, splenomegaly, liver enlargement, eyelid edema and skin rash between the two groups(P> 0.05), but the incidence of cheek-pharyngitis in EBV group was significantly higher than that in CMV group(P<0.05). There was no significant difference in the proportion of lymph node enlargement, cough, fever, pharyngeal cheek inflammation, eyelid edema and wheeze as the first symptoms between the two groups(P> 0.05), but the proportion of nasal obstruction/runny nose as the first symptoms in EBV group was significantly higher than that in CMV group(P<0.05). There was no significant difference in RBC, WBC, lymphocyte and neutrophil count between the two groups(P> 0.05), but platelet count(PLT), alanine aminotransferase(ALT) and atypical lymphocyte count(A-lym) in EBV group were significantly higher than those in CMV group(P<0.05). Conclusion: Fever is the first symptom of IM children infected with EBV and CMV, but compared with CMV, the incidence of nasal obstruction/runny nose is higher in children infected with EBV. The increase of platelet, alanine aminotransferase and atypic lymphocyte is increased, and the damage of liver function is more serious.