儿童传染性单核细胞增多症并发肝损害的现状调查及风险分析

Investigation and risk analysis of infectious mononucleosis complicated with liver damage in children

目的探讨儿童传染性单核细胞增多症(IM)伴肝损害现状,并分析其发病风险。方法选取2017年12月-2020年12月东莞东华医院接收的145例IM患儿作为研究对象,按照是否有肝功能损害将其分为肝损害组与非损害组,比较2组年龄、性别、主要临床表现、外周血指标等情况,分析其风险。结果年龄越大伴肝损害发生率越高(P<0.05);男女伴肝损害发生率无统计学差异(P>0.05);相比非损害组,肝损害组的IM持续发热时间在7d以上、伴脾脏或肝脏肿大患儿均显著增加(P<0.05);相比非损害组,肝损害组的WBC>10×10^(9)/L患儿占比明显增加(P<0.05)。结论年龄、发热时间、持续发热时间7d以上、肝脾肿大及外周血异常淋巴细胞等在IM伴肝损害中明显增加,通过开展早期免疫调节和护肝治疗可能减轻IM患儿肝功能损害程度。

Objective To investigate the status and risk of infectious mononucleosis(IM)with liver damage in children.Methods A total of 145 children with IM received in our hospital from December 2017 to December 2020 were selected as the research object.They were divided into liver damage group and non-damage group according to whether there was liver function damage.The differences of age,gender,main clinical manifestations and peripheral blood indexes between the two groups were compared,and their significant risks were analyzed.Results It was found that the older the age,the higher the incidence of liver damage(P<0.05);However,there was no significant difference between the two groups(P>0.05);Compared with the non-injury group,the im lasting fever time of more than 7 days and patients with splenomegaly or liver enlargement in the liver injury group were significantly increased(P<0.05);Compared with the non-injury group,the WBC of the liver injury group was>10×10^(9)/L patients increased significantly(P<0.05).Conclusion Age,fever time,continuous fever time of more than 7 days,hepatosplenomegaly and abnormal peripheral blood lymphocytes increased significantly in IM with liver damage;Early effective immunomodulation and liver protection therapy may reduce the degree of liver function damage in children with IM.