传染性单核细胞增多症合并肝损害的临床特征  

Clinical Features of Infectious Mononucleosis with Liver Damage in Children

作　　者：罗泽民[1,2] 苏海涛[1,2] 谢娜[1,2] 

机构地区：[1]四川省妇幼保健院 [2]四川省妇女儿童医院儿科,成都610041

出　　处：《华西医学》2012年第8期1190-1193,共4页West China Medical Journal

摘　　要：目的总结儿童传染性单核细胞增多症(IM)合并肝损害的临床特点及相关因素。方法对2000年1月-2012年1月入院收治48例合并肝损害IM与120例无肝损害IM的患儿年龄、性别、主要症状和体征、系统损害、实验室检查等资料进行回顾性分析。结果合并肝损害IM患儿血小板减少、异形淋巴细胞增加、丙氨酸氨基转换酶和天门冬氨酸氨基转移酶等血清酶学异常、持续发热、中重度肝脾肿大,以及多系统损害发生率较高;而咽峡炎、皮疹和浅表淋巴结肿大发生率较低;IM合并肝损害与发病年龄、性别无明显相关(r=0.127,0.075,P<0.05)。结论 IM合并肝损害表现为持续发热、肝脾肿大、肝酶异常、血小板减少、异形淋巴细胞增加较常见。及时作肝功能等辅助检查,及早发现和干预IM肝损害,有助于减少重症IM的发生。Objective To summarize the clinical characteristics and related factors of infectious mononucleosis（IM） combined with liver damage.Methods We retrospectively analyzed the clinical data of 48 child patients with IM with liver damage and 120 child patients with IM without liver damage treated from January 2000 to January 2012.The data included age,gender,main symptoms and signs,systematic damage,laboratory characteristics,etc.Results Patients with IM with liver damage had a high incidence of thrombocytopenia,abnormal levels of alanine aminotransferase and aspartate aminotransferase,continuous fever,moderate to severe liver and spleen enlargement,and multi-system damage,and a low incidence of angina,skin rash,and superficial lymph node enlargement.The relationship between IM with liver damage and patients＇ age and gender was not statistically significant（r=0.127,P=0.254;r=0.075,P=0.329）.Conclusions Patients with IM with liver damage show the following common symptoms： persistent fever,hepatosplenomegaly,abnormal liver enzymes,thrombocytopenia,and increased variability in lymphocytes.It is favorable to reduce the incidence of severe IM by examining liver function in time,discovering and intervening liver damage as early as possible.

关 键 词：儿童传染性单核细胞增多症 肝功能损害 并发症 

分 类 号：R512.7[医药卫生—内科学]