Infectious mononucleosis (IM), primarily caused by the Epstein-Barr virus (EBV), manifests as the classic triad of fever, pharyngitis, and cervical lymphadenopathy. Severe cases may involve organ damage, most commonly...Infectious mononucleosis (IM), primarily caused by the Epstein-Barr virus (EBV), manifests as the classic triad of fever, pharyngitis, and cervical lymphadenopathy. Severe cases may involve organ damage, most commonly affecting the liver. Diagnosis relies on a combination of clinical presentation and laboratory parameters, with commonly used indicators including EBV-specific antibodies, EBV-DNA load, and the ratio of atypical lymphocytes. Treatment primarily involves symptomatic supportive care, with a cautious approach to the routine use of antiviral medications. In recent years, significant research in traditional Chinese medicine has been conducted in China, showing promising advancements. This article provides a comprehensive review of EBV-induced infectious mononucleosis, offering insights for clinical diagnosis and treatment.展开更多
Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorab...Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.展开更多
Objective： To evaluate the clinical efficacy and safety of Chinese drugs for the treatment of children＇s infectious mononucleosis （CIM）. Methods： Sixty CIM patients were assigned into the treated group and the co...Objective： To evaluate the clinical efficacy and safety of Chinese drugs for the treatment of children＇s infectious mononucleosis （CIM）. Methods： Sixty CIM patients were assigned into the treated group and the control group, patients in the treated group were administered with Chinese herbal decoction, and those in the control group were treated with intravenous dripping of ganciclovir 10 mg/kg per day, for a treatment course of 14 days. Results： The total effective rate was 96.0% in the treated group and 97.1% in the control group, showing insignificant difference between groups. The efficacy in the treated group was superior to that in the control group on the fever clearance time （3.0 ± 1.5 days vs 4.9 ± 3.9 days ） and the disappearance time of cervical lymph node swelling （0.8 ± 1.0 score vs 1.5 ± 1.2 score）, showing statistical significance （all P〈0.05）. T-cell subsets were markedly improved in both groups after treatment. Adverse reaction occurred in four cases of the control group. Conclusion： Using Chinese herbs for clearing heat, removing toxin, activating blood circulation, and dissolving stasis is effective and safe for the treatment of CIM. It can effectively improve the clinical symptoms and shows a certain effect on immune regulation.展开更多
目的探讨传染性单核细胞增多症患儿调节性T细胞(regulatory T cell,Treg)/辅助性T细胞(helper T cell,Th)17免疫失衡与治疗后Epstein-Barr病毒(EBV)-DNA仍阳性的相关性,为传染性单核细胞增多症的治疗及预后评估提供重要标志物。方法以2...目的探讨传染性单核细胞增多症患儿调节性T细胞(regulatory T cell,Treg)/辅助性T细胞(helper T cell,Th)17免疫失衡与治疗后Epstein-Barr病毒(EBV)-DNA仍阳性的相关性,为传染性单核细胞增多症的治疗及预后评估提供重要标志物。方法以2021年1月至2023年6月就诊于秦皇岛市工人医院的88例传染性单核细胞增多症患儿作为研究对象。患儿接受基于阿昔洛韦或更昔洛韦的标准化治疗并持续随访,根据治疗14d时患儿EBV-DNA载量是否仍为阳性分为EBV-DNA阴性组(n=70)和EBV-DNA阳性组(n=18)。对比两组患儿一般临床资料、治疗相关特征、治疗前T细胞亚群、炎性细胞因子、免疫球蛋白等指标的差异。将单因素分析有意义的指标进行Spearman相关性分析及多因素Logistic回归分析,评价各差异性指标与传染性单核细胞增多症患儿治疗14d后EBV-DNA仍阳性的相关性和危险因素。结果EBV-DNA阳性组患儿平均住院时间、平均体温恢复时间、淋巴结肿大恢复时间均显著长于EBV-DNA阴性组患儿(P<0.05);EBV-DNA阳性组患儿平均CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)比值、Treg细胞比例、Treg/Th17比值、血清IL-4水平均显著低于EBV-DNA阴性组患儿,平均Th17细胞比例及血清IFN-γ水平均显著高于EBV-DNA阴性组患儿(P<0.05);多因素Logistic回归分析表明传染性单核细胞增多症患儿CD4^(+)T淋巴细胞比例及Treg细胞比例较低、Th17细胞比例较高及Treg/Th17比值较低均是规范治疗14d后EBV-DNA仍阳性的危险因素(P<0.05)。结论传染性单核细胞增多症患儿治疗前T细胞亚群比例特征、Treg/Th17免疫失衡严重程度、Th1/Th2细胞因子水平及免疫球蛋白水平与治疗14d后EBV-DNA仍阳性具有显著相关性,密切监测并促进患儿免疫-炎症水平恢复平衡对于提高传染性单核细胞增多症治疗预后具有重要临床意义。展开更多
文摘Infectious mononucleosis (IM), primarily caused by the Epstein-Barr virus (EBV), manifests as the classic triad of fever, pharyngitis, and cervical lymphadenopathy. Severe cases may involve organ damage, most commonly affecting the liver. Diagnosis relies on a combination of clinical presentation and laboratory parameters, with commonly used indicators including EBV-specific antibodies, EBV-DNA load, and the ratio of atypical lymphocytes. Treatment primarily involves symptomatic supportive care, with a cautious approach to the routine use of antiviral medications. In recent years, significant research in traditional Chinese medicine has been conducted in China, showing promising advancements. This article provides a comprehensive review of EBV-induced infectious mononucleosis, offering insights for clinical diagnosis and treatment.
基金supported by the National Natural Science Foundation of China (82002130)supported by the CAMS Innovation Fund for Medical Sciences (2019-I2M-5-026)
文摘Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.
基金Supported by the Natural Science Foundation of Beijing Municipal Science and Technology Committee(No. z0005190042511)the Basic-clinical Cooperative Foundation of Capital Medical University(No.2006JL50)
文摘Objective： To evaluate the clinical efficacy and safety of Chinese drugs for the treatment of children＇s infectious mononucleosis （CIM）. Methods： Sixty CIM patients were assigned into the treated group and the control group, patients in the treated group were administered with Chinese herbal decoction, and those in the control group were treated with intravenous dripping of ganciclovir 10 mg/kg per day, for a treatment course of 14 days. Results： The total effective rate was 96.0% in the treated group and 97.1% in the control group, showing insignificant difference between groups. The efficacy in the treated group was superior to that in the control group on the fever clearance time （3.0 ± 1.5 days vs 4.9 ± 3.9 days ） and the disappearance time of cervical lymph node swelling （0.8 ± 1.0 score vs 1.5 ± 1.2 score）, showing statistical significance （all P〈0.05）. T-cell subsets were markedly improved in both groups after treatment. Adverse reaction occurred in four cases of the control group. Conclusion： Using Chinese herbs for clearing heat, removing toxin, activating blood circulation, and dissolving stasis is effective and safe for the treatment of CIM. It can effectively improve the clinical symptoms and shows a certain effect on immune regulation.
文摘目的探讨传染性单核细胞增多症患儿调节性T细胞(regulatory T cell,Treg)/辅助性T细胞(helper T cell,Th)17免疫失衡与治疗后Epstein-Barr病毒(EBV)-DNA仍阳性的相关性,为传染性单核细胞增多症的治疗及预后评估提供重要标志物。方法以2021年1月至2023年6月就诊于秦皇岛市工人医院的88例传染性单核细胞增多症患儿作为研究对象。患儿接受基于阿昔洛韦或更昔洛韦的标准化治疗并持续随访,根据治疗14d时患儿EBV-DNA载量是否仍为阳性分为EBV-DNA阴性组(n=70)和EBV-DNA阳性组(n=18)。对比两组患儿一般临床资料、治疗相关特征、治疗前T细胞亚群、炎性细胞因子、免疫球蛋白等指标的差异。将单因素分析有意义的指标进行Spearman相关性分析及多因素Logistic回归分析,评价各差异性指标与传染性单核细胞增多症患儿治疗14d后EBV-DNA仍阳性的相关性和危险因素。结果EBV-DNA阳性组患儿平均住院时间、平均体温恢复时间、淋巴结肿大恢复时间均显著长于EBV-DNA阴性组患儿(P<0.05);EBV-DNA阳性组患儿平均CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)比值、Treg细胞比例、Treg/Th17比值、血清IL-4水平均显著低于EBV-DNA阴性组患儿,平均Th17细胞比例及血清IFN-γ水平均显著高于EBV-DNA阴性组患儿(P<0.05);多因素Logistic回归分析表明传染性单核细胞增多症患儿CD4^(+)T淋巴细胞比例及Treg细胞比例较低、Th17细胞比例较高及Treg/Th17比值较低均是规范治疗14d后EBV-DNA仍阳性的危险因素(P<0.05)。结论传染性单核细胞增多症患儿治疗前T细胞亚群比例特征、Treg/Th17免疫失衡严重程度、Th1/Th2细胞因子水平及免疫球蛋白水平与治疗14d后EBV-DNA仍阳性具有显著相关性,密切监测并促进患儿免疫-炎症水平恢复平衡对于提高传染性单核细胞增多症治疗预后具有重要临床意义。
