传染性单核细胞增多症患儿的临床症状和实验室检查分析

Analysis of clinical symptoms and laboratory examination in children infected with infectious mononucleosis

目的通过分析传染性单核细胞增多症(IM)患儿的临床症状和实验室检查结果,以提高临床早期诊断水平。方法回顾性分析2016年7月-2018年12月本院儿科收治的203例传染性单核细胞增多症患儿的临床表现和实验室检查指标,并比较IM组患儿实验室检查指标与对照组的变化。结果203例患儿均有不同程度的发热,咽峡炎、淋巴结肿大、肝肿大、眼睑浮肿等症状也较为多见。203例患儿中抗EBV-VCA-IgM和抗EBV-VCA-IgG抗体阳性,且抗EBV-NA-IgG阴性89例;抗EBV-VCA-IgM抗体阳性,且抗EBV-VCA-IgG和抗EBV-NA-IgG抗体阴性74例;抗EBV-VCA-IgM抗体阴性,但EBV-VCA-IgG抗体阳性,且为低亲合力抗体40例。IM组患儿白细胞总数、淋巴细胞百分率、异型淋巴细胞百分率、ALT、AST、LDH与对照组比较均有明显升高,差异均有统计学意义(P<0.01)。IM组患儿T淋巴细胞亚群CD3^+、CD8^+T细胞升高,CD4^+T细胞和CD4^+/CD8^+T细胞比值降低,与对照组比较差异有统计学意义(P<0.01)。结论充分认识传染性单核细胞增多症患儿的临床症状和实验室检查特征,可提高此病的临床诊断水平。

Objective To analyze the clinical symptoms and laboratory examination in children infected with infectious mononucleosis,and to improve the early diagnosis.Methods The clinical manifestations and laboratory examination indexes of 203 children with infectious mononucleosis admitted to the department of pediatrics of our hospital from July 2016 to December 2018 were retrospectively analyzed,and the changes of laboratory examination indexes of children in the IM group and the control group were compared.Results 203 cases of children had different degrees of fever,and pharyngitis,lymphadenopathy,hepatomegaly,and eyelid edema were more common.Among 203 children,anti-EBV-VCA-IgM and anti-EBV-VCA-IgG antibodies were positive,and anti-EBV-NA-IgG was negative in 89 cases;anti-EBV-VCA-IgM antibodies were positive,and anti-EBV-VCA-IgG and anti-EBV-VCA-IgG antibodies were positive.EBV-NA-IgG antibody was negative in 74 cases;anti-EBV-VCA-IgM antibody was negative,but EBV-VCA-IgG antibody was positive and 40 cases were low-affinity antibodies.Compared with the control group,the total number of white blood cells,the percentage of lymphocytes,the percentage of atypical lymphocytes,ALT,AST,and LDH in children in the IM group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).CD3+and CD8+T cells in T lymphocyte subsets of children in IM group increased,and the ratio of CD4+T cells and CD4+/CD8+T cells decreased,with the differences statistically significant compared with the control group(P<0.01).Conclusion To fully understand the clinical symptoms and laboratory examination characteristics of children with infectious mononucleosis can improve the diagnosis level.