儿童传染性单核细胞增多症不同抗病毒治疗策略的比较研究

Comparative study of different antiviral treatment strategies for children with infectious mononucleosis

目的:比较儿童传染性单核细胞增多症(IM)在不同抗病毒药物干预下的疗效,为优化其治疗方案提供证据。方法:回顾性分析我院2015年1月–2020年12月确诊的235例IM患儿的治疗策略,根据用药情况分为无抗病毒药物组、干扰素α1b组、更昔洛韦组、干扰素α1b+更昔洛韦组,收集患者一般资料以及发热、咽部充血/扁桃体肿大、淋巴结肿大、肝脾增大、ALT、异型淋巴细胞等指标进行统计分析。结果:男童发病率(61.7%)高于女童(38.3%),平均发病年龄5~6岁,住院天数8~9 d,体温平均4~5 d恢复正常,余指标平均8~9 d恢复正常。四组患儿各项指标的完全缓解时间对比无统计学差异(P>0.05)。结论:IM患者是否应用抗病毒药物对病情缓解的影响不大,需进一步探讨在IM儿童患者中抗病毒药物应用的必要性。

Objective:To compare the effi cacy of different antiviral drugs for children with infectious mononucleosis(IM)in order to provide evidence for treatment scheme optimization.Methods:A retrospective study was conducted on 235 children with IM in our hospital from January 2015 to December 2020,which were divided into no antiviral drug group,interferonα1b group,ganciclovir group and interferonα1b combined with ganciclovir group.Data of the children including the general information,fever,pharyngeal hyperemia/antiadoncus,lymphadenectasis,liver/spleen enlargement,alanine aminotransferase(ALT),atypical lymphocytes were collected and statistically analyzed.Results:The morbidity was higher in boys(61.7%)than girls(38.3%).The mean age of IM onset was 5–6 years old.The mean duration in hospital was 8–9 days.The body temperature of children returned to normal in an average of 4–5 days and other index returned to normal in an average of 8–9 days.Time of complete remission in the four groups showed no signifi cant difference(P>0.05).Conclusion:The application of antiviral drugs in IM patients has little effect on remission.It is necessary to further explore the necessity of antiviral drugs in IM children.