儿童EB病毒相关传染性单核细胞增多症伴肝功能损害的相关因素分析

Analysis of factors associated with liver function damage in children with EB virus related infectious mononucleosis

目的研究儿童EB病毒相关传染性单核细胞增多症(IM)伴肝功能损害的相关因素,提高对肝功能损害的认识。方法回顾性分析2017年5月至2020年5月本院101例IM患儿(男63例,女38例,平均年龄3.61岁),以丙氨酸氨基转移酶(ALT)>50 U/L和/或天门冬氨酸氨基转移酶(AST)>40 U/L定义为肝功能异常,以ALT≥100 U/L和/或AST≥100 U/L定义为肝功能损害。分析不同年龄、性别患儿肝功能异常和损害发生率的差异及有无肝功能损害患儿住院时间、热峰及发热时间的差异。结果肝功能异常发生率在不同年龄组患儿之间比较,差异无统计学意义(χ^(2)=3.093,P=0.213)。<3岁组与3~6岁组肝功能损害发生率比较,差异无统计学意义(P>0.05);<3岁组与>6岁组肝功能损害发生率比较,差异有统计学意义(χ^(2)=11.366,P<0.001);3~6岁组与>6岁组肝功能损害发生率比较,差异有统计学意义(χ^(2)=10.266,P<0.001)。女性IM患儿肝功能异常和肝功能损害发生率分别为94.7%(36/38)、63.1%(24/38),均高于男性患儿73.0%(46/63)、34.9%(22/63),差异均有统计学意义(均P<0.05)。肝功能损害患儿热峰及发热时间与无肝功能损害患儿比较,差异均无统计学意义(均P>0.05);有肝功能损害患儿住院时间为(7.23±3.89)d,高于无肝功能损害患儿(5.56±1.93)d,差异有统计学意义(P<0.05)。结论儿童IM伴肝功能异常和损害的发生率高,并与患儿年龄、性别、住院时间有关,对伴有不同程度肝功能损害的患儿应加强其监护。

Objective To explore the related factors and incidence of liver function damage in children with EB virus related infectious mononucleosis(IM),and to raise the level of understanding on liver function damage.Methods A total of 101 cases of children diagnosed with IM were collected from our hospital from May 2017 to May 2020,including 63 males and 38 females,with an average age of 3.61 years old.The level of alanine aminotransferase(ALT)>50 U/L and/or aspartate aminotransferase(AST)>40 U/L were defined as abnormal liver function,and the level of ALT≥100 U/L and/or AST≥100 U/L were defined as liver function damage.The incidences of abnormal liver function and liver function damage were compared between age and gender,and the hospital stay,thermal spike,and fever time were compared between children with and without liver function damage.Results There was no statistically significant difference in the incidence of abnormal liver function among different age groups(χ^(2)=3.093,P=0.213).There was no statistically significant difference in the incidence of liver function damage between the<3 years old group and the 3-6 years old group(P>0.05);there was a statistically significant difference in the incidence of liver function damage between the<3 years old group and the>6 years old group(χ^(2)=11.366,P<0.001);there was a statistically significant difference in the incidence of liver function damage between the 3-6 years old group and the>6 year old group(χ^(2)=10.266,P<0.001).The incidences of abnormal liver function and liver function damage in female IM children were 94.7%(36/38)and 63.1%(24/38),respectively,which were higher than those in male IM children[73.0%(46/63)and 34.9%(22/63)],with statistically significant differences(both P<0.05).There were no statistically significant differences in the thermal spike and fever time between children with liver function damage and children without liver function damage(both P>0.05);the hospital stay of children with liver function damage was(7.23±3.89)d,which was higher than that of children without liver function damage[(5.56±1.93)d],with a statistically significant difference(P<0.05).Conclusions Children with IM are facing a status of being in high incidences of abnormal liver function and liver function damage,which is related to age,sex,and hospital stay.It is necessary to strengthen the protection to children with different degrees of liver function damage.