儿童传染性单核细胞增多症合并肝损伤患儿的临床特点及血清学指标研究

Clinical Characteristics and Serological Indexes of Children with Infectious Mononucleosis Complicated with Liver Injury

目的:探究儿童传染性单核细胞增多症合并肝损伤患儿的临床特点及血清学指标。方法:筛选我院2021年1月—2022年7月收治的60例传染性单核细胞增多症患儿,根据是否合并肝损伤分为肝损伤组(26例)和无肝损伤组(34例),并对比分析其临床特点和血清学指标变化。结果:合并肝损伤的传染性单核细胞增多症患儿以持续发热和中重度肝脾肿大为突出表现,部分患儿合并皮疹、咽峡炎和浅表淋巴结肿大等症状。肝损伤组患儿的AST、ALT和TBil等肝功能相关血清水平均显著高于对照组(P<0.05)。肝损伤组患儿的淋巴细胞数量>40%和异型淋巴细胞>10%的占比显著多于无肝损伤组患儿(P<0.05),两组患儿白细胞数量对比无显著差异(P>0.05)。结论:传染性单核细胞增多症继发肝损伤患儿,多表现为持续发热、肝脾肿大、肝酶异常、异型淋巴结细胞增多,在病程早期展开肝功能检查,有助于尽早发现肝损伤,做出对症支持治疗,避免病情发展至危重阶段。

Objective:To investigate the clinical characteristics and serological indexes of children with infectious mononucleosis complicated with liver injury.Methods:A total of 60 children with infectious mononucleosis admitted to our hospital from January 2021 to July 2022 were selected and divided into liver injury group(26 cases)and non-liver injury group(34 cases)according to whether they were complicated with liver injury.The clinical characteristics and changes of serological indicators were compared and analyzed.Results:The children with infectious mononucleosis complicated with liver injury were characterized by persistent fever and moderate to severe hepatic and splenomegaly,and some children were complicated with rash,pharyngitis and superficial lymphadenopathy.The serum levels of AST,ALT and TBil in the liver injury group were significantly higher than those in the control group(P<0.05).The proportion of lymphocytes>40%and heterotypic lymphocytes>10%in the liver injury group were significantly higher than those in the non-liver injury group(P<0.05).There was no significant difference in the number of white blood cells between the two groups(P>0.05).Conclusion:Children with liver injury secondary to infectious mononucleosis are mostly characterized by persistent fever,hepatosplenomegaly,abnormal liver enzymes,and allotypic lymphadenocytosis.Liver function tests at the early stage of the disease can help to detect liver injury as early as possible,make symptomatic and supportive treatment,and avoid the development of the disease to a critical stage.