EB病毒相关传染性单核细胞增多症81例临床分析

Clinical Analysis of 81 Cases of Infectious Mononucleosis in Children

目的:分析儿童传染性单核细胞增多症临床特点,提高对传染性单核细胞增多症的认识。方法:回顾性分析2018年1月至2020年9月就诊于我院传染性单核细胞增多症患儿81例的临床资料,并总结分析其临床特点。结果:77例患儿治愈出院,3例患儿好转出院,1例转院,其中男女比例:2.52:1 (58男,23女),发病高峰年龄集中在1~6岁,临床表现中以发热、颈部淋巴结肿大、咽峡炎等临床表现多见,其中发热69例,占85.18%;颈部淋巴结肿大70例,占86.41%;咽峡炎63例,占77.77%,临床表现变化多样,入院时易误诊,其中误诊为化脓性扁桃体炎、颈部淋巴结炎、川崎病、肾小球肾炎等多见,入院时误诊率为30.43%。病程中合并肺炎26例,占比32.09%;肝损害21例,占比25.92%;心肌损害44例,占比54.32%;中性粒细胞减少12例,占比14.81%;合并蛋白尿9例,占11.11%;合并贫血1例,占1.23%;其中1例诊断并发EB病毒相关嗜血综合征,占1.23%。结论:儿童传染性单核细胞增多症临床表现多样,多发于男性,且以1~6岁常见,肺炎、肝损害以及心肌损害为主要合并症,易误诊,多数预后好。

Objective: To analyze clinical characteristics of infectious mononucleosis in children, improve the knowledge of infectious mononucleosis. Methods: The clinical data of 81 children with infectious mononucleosis in our hospital from January 2018 to September 2020 were retrospectively analyzed, and their clinical characteristics were summarized. Results: 77 cases cured and discharged, 3 cases improved and discharged, 1 case of courtyard, percentage of men and women: 2.52:1 (58 male, female), peak onset age concentrated in 1 to 6 years of age, clinical manifestation was in fever, cervical lymph node enlargement, clinical manifestations, such as angina;69 patients with fever (85.18%);Neck lymph nodes 70 cases, accounted for 86.41%;Angina 63 cases (77.77%);the clinical manifestations were of variety, easy misdiagnosis on admission, including the misdiagnosis for suppurative tonsillitis, neck lymph node phlogistic, kawasaki disease, glomerulonephritis, etc., the misdiagnosis rate was 30.43%, in the course of merging pneumonia 26 cases, accounted for 32.09%;liver damage 21 cases, accounted for 25.92%;Myocardial damage in 44 cases, accounted for 54.32%;Neutropenia in 12 cases, accounted for 14.81%;Merger of proteinuria, 9 cases (11.11%);Merger of anemia in 1 case (1.23%);among them, 1 case was diagnosed concurrent epstein-barr virus associated blood syndrome, accounting for 1.23%. Conclusion: The clinical manifestations of infectious mononucleosis in children are various, most of them are male, and in 1~6 years old. Pneumonia, liver damage and myocardial damage are the main complications, which are easy to be misdiagnosed and most of them have good prognosis.