儿童传染性单核细胞增多症临床特征分析

Analysis of clinical characteristics of infectious mononucleosis in children

目的分析传染性单核细胞增多症(IM)患儿的临床特征,进一步指导临床诊疗。方法选择2017年1月1日至2019年12月31日在我院确诊为IM的住院患儿119例为观察组,同时选择健康体检儿童62例作为对照组。获取临床及实验室检查资料,并加以分析。结果研究发现,EB病毒抗体IgA阳性者31例,占26.05%,IgM阳性者107例,占89.92%,IgG阳性者33例,占27.73%。异型淋巴细胞≥10%者54例,占45.37%。合并支原体抗体IgM阳性者35例,占29.41%。完善细胞免疫功能者83例,CD3^(+)、CD3^(+)CD8^(+)与对照组相比明显升高,差异有统计学意义(P<0.01);CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)、CD19^(+)与对照组相比明显降低,差异有统计学意义(P<0.05);合并肝功能受损者59例,占49.58%。结论IM急性期IgM抗体阳性为临床诊断的重要依据;IM引起细胞免疫功能紊乱及肝功能异常较常见;疾病早期外周血细胞形态改变较明显;因此分析IM患儿的临床特征有助于指导临床医生对于疾病的早期诊治,有助于早期分析病情、制定用药方案及判断预后。

Objective To analyze the clinical characteristics of children with infectious mononucleosis(IM)and to further guide clinical diagnosis and treatment.Methods A total of 119 hospitalized children with IM diagnosed in our hospital from January 1,2017 to December 31,2019 were selected as the observation group,and 62 healthy children were selected as the control group.Clinical and laboratory data were obtained and analyzed.Results The results showed that 31 cases(26.05%)were IgA positive to EB virus antibody,107 cases(89.92%)were IgM positive,and 33 cases(27.73%)were IgG positive.There were 54 patients with atypical lymphocytes≥10%(45.37%).There were 35 cases(29.41%)complicated with IgM antibody positive.CD3^(+) and CD3^(+)CD8^(+) were significantly higher in 83 patients with improved cellular immune function than in the control group(P<0.01);CD3^(+)CD4^(+),CD4^(+)/CD8^(+),and CD19^(+) were significantly lower than those in the control group(P<0.05);59 cases(49.58%)were with impaired liver function.Conclusion Positive IgM antibody in acute stage of IM is an important basis for clinical diagnosis.The dysfunction of cellular immunity and abnormal liver function caused by IM are common.The morphological changes of peripheral blood cells are obvious in the early stage of disease.Therefore,the analysis of clinical characteristics of children with IM is helpful to guide clinicians in the early diagnosis and treatment of the disease,contributing to the early analysis of the disease condition,formulation of medication regimen and judgment of prognosis.