儿童CMV感染致传染性单核细胞增多综合征的临床特征  

Clinical manifestation of children with infectious mononucleosis syndrome related to Cytomegalovirus infection

作　　者：蒋伟明[1] 王敏[1] 熊安秀[1] 

机构地区：[1]三峡大学儿科研究所宜昌市中心人民医院儿科,湖北宜昌443003

出　　处：《中国热带医学》2015年第10期1234-1237,共4页China Tropical Medicine

摘　　要：目的探讨儿童巨细胞病毒(CMV)感染致传染性单核细胞增多综合征的临床特征,为临床早期诊断提供依据。方法回顾性分析32例儿童CMV感染致传染性单核细胞增多综合征患儿(CMV组)的临床特征及其治疗转归,并与同期46例确诊EBV感染所致传染性单核细胞增多症患儿(EBV对照组)进行对比分析。结果 32例患儿(CMV组)首诊准确14例,首诊准确率为43.7%,其中18例首诊为其他疾病。CMV组患儿表现为发热、咽峡炎、淋巴结肿大和脾肿大的临床特征,差异有统计学意义(P<0.05);系统损害表现为恶心呕吐、腹痛腹泻,心电图异常,差异有统计学意义(P<0.05);异型淋巴细胞增多,肝功能损害,差异有统计学意义(P<0.05)。所有确诊患儿经更昔洛韦治疗后痊愈。结论CMV感染致传染性单核细胞增多综合症临床表现与传染性单核细胞增多症相似,易累及系统损害,在临床上应尽早对消化系统、血液系统、呼吸系统检查以及外周血象、肝功能、心肌酶谱等实验室检查,防止误诊,更昔洛韦治疗有效。Objective To explore clinical manifestation of children with infectious mononucleosis syndrome related toCytomegalovirus（CMV） infection, and provide the basis for early clinical diagnosis. Methods The clinical manifestation andtreatment outcome of 32 cases with infectious mononucleosis syndrome related to CMV（CMV group） was retrospectivelyanalyzed, at the same period, 46 cases with infection mononucleosis syndrome by Epstein- Barr virus（EBV） infection（EBVgroup） were comparatively analyzed for control group. Results A total of 14 cases were first accurately diagnosed in CMVgroup of the 32 cases, the first diagnostic accuracy was 43.7%, while 18 cases were first diagnosed as other diseases. Theclinical manifestation of CMV group were characterized by fever, isthmopyra, lymphadenectasis, and splenomegaly, thedifference was statistically significant（P〈0.05）; System damage performance such as nausea, vomiting,abdominal pain, diarrhea,abnormal electrocardiogram（ECG）, the difference was statistically significant（P〈0.05）; Heterotypic lymphocytes increased,liver function damage, the difference was statistically significant（P〈0.05）. All confirmed cases recovered after treatment byganciclovir（GCV）. Conclusion The clinical manifestation of children with infectious mononucleosis syndrome by CMV wassimilar to infectious mononucleosis syndrome by EBV, which was easily involved with system damage. It is necessary to payattention to digestive system, hematologic system, respiratory system, and laboratory examination such as peripheral hemogram,liver function, myocardial enzymes to prevent misdiagnosis. The treatment by GCV is effective.

关 键 词：巨细胞病毒 传染性单核细胞增多综合征 临床特征 

分 类 号：R512.7[医药卫生—内科学]