57例儿童传染性单核细胞增多症的临床特点  

Clinical Features of Infectious Mononucleosis in 57 Children

作　　者：卢成瑜[1] 梁洁芳[1] 陈福雄[1] 

机构地区：[1]广州医学院第一附属医院儿科,广东广州510120

出　　处：《广州医学院学报》2009年第1期58-60,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨儿童传染性单核细胞增多症的临床特点。方法:收集本院儿科2003年4月至2008年6月57例儿童传染性单核细胞增多症的临床资料进行回顾性分析。结果:57例患儿中持续发热5 d以上者37例(37/57,64.9%),无发热5例(5/57,8.8%),淋巴结肿大54例(54/57,94.7%);合并支原体感染21例(21/39,53.8%);合并肺炎13例(13/57,22.8%),其中支原体肺炎6例;异形淋巴细胞计数10%以上者43例(43/57,72%),血清谷丙转氨酶升高35例(35/57,63.6%),异型淋巴细胞比例与肝功能存在正相关关系(r=0.562);合并支原体感染的IM病例在发热天数、淋巴结肿大、肝脾肿大、白细胞数、异型淋巴细胞、血清ALT等临床表现上与无合并支原体感染的IM病例差异无显著性,但在住院天数和住院费用上明显高于后者。结论:传染性单核细胞增多症的外周血异型淋巴细胞比例与血清ALT存在正相关关系,虽然合并支原体感染的IM病例在临床表现上无显著性变化,但是临床上仍要加强支原体的检查和治疗。Objective： To explore the clinical features of infectious mononucleosis （IM） in 57 children. Methods： Clinical data of 57 children with IM treated in our department between April 2003 and June 2008 were retrospectively analyzed. Results：Of the 57 children with IM, 37 （37/57,64.9%） suffered persistent fever for 5 days or more,5 （5/57,8.8%） were febrile, 54 （54/57,94.7%） had enlarged lymph nodes,21 （21/39,53.8%） had complicating infections with mycoplasma, 13 （ 13/57,22. 8% ） had pneumonia （ including 6 cases of mycoplasma pneumonia）, 43 （43/57,72%） had atypical lymphocyte counts 〉 10% , and 35 （35/57,63.6%） had increased serum ALT. Moreover, the percentage of atypical lymphocytes was positively con＇elated with liver function. There were no differences in clinical manifestations such as duration of fever, enlarged lymph nodes, hepatosplenomegaly, leukocyte counts, percentage of atypical lymphocytes and serum ALT level between IM cases with and without complicating mycoplasma infection, however, occurrence of mycoplasma infection did increase days of hospital stay and medical costs. Conclusion：The percentage of atypical lymphocytes and liver function were significantly correlated in IM cases. Test and therapy of mycoplasma should be emphasized in clinical practices, even if clinical manifestations may not show difference between IM cases with or without complicating mycoplasma infection.

关 键 词：儿童 传染性单核细胞增多症 特点 

分 类 号：R512.7[医药卫生—内科学]