传染性单核细胞增多症伴冠状动脉扩张病例分析  

Case analysis of infectious mononucleosis with coronary artery dilatation

作　　者：刘京晶 郑春华[2] 李晓惠[1] 包敏[2] 曹爱梅[2] 任军[2] 刘波[2] 刘艳[2] LIU Jinxing ZHENG Chunhua LI Xiaohui BAO Min CAO Aimei BEN Jun LIU Bo LIU Yan(Department of Cardiology, Children＇s Hospital, Capital Institute of Pediatrics, Beijing 100020, China Department of Ultrasonic Cardiogram, Children＇s Hospital, Capital Institute of Pediatrics, Beijing 100020, China)

机构地区：[1]首都儿科研究所附属儿童医院心内科,北京100020 [2]首都儿科研究所附属儿童医院心功能室,北京100020

出　　处：《中国医药导报》2017年第29期76-79,共4页China Medical Herald

摘　　要：目的探索传染性单核细胞增多症(IM)合并冠状动脉扩张的病例特点。方法收集2015年5月~2016年12月于首都儿科研究所附属儿童医院确诊IM的病例,完善超声心动图检查,用Z值评估冠状动脉扩张情况,分析IM合并冠状动脉扩张病例的临床特点。结果(1)临床特点:IM共344例,伴冠状动脉扩张15例,IM合并冠状动脉扩张发病率为4.4%;年龄为(3.47±1.61)岁;男8例(53.3%),女7例(46.7%);临床表现为发热15例(100.0%),淋巴结肿大14例(93.3%);血常规白细胞升高14例(93.3%),淋巴细胞比例升高15例(100.0%),异型淋巴细胞比例升高14例(93.3%);细胞免疫检查14例异常(93.3%)。(2)冠状动脉扩张情况:自起病至发生冠状动脉扩张所经时间中位数为5(4,8)d,冠状动脉扩张持续时间中位数为17(7,41)d;冠状动脉扩张者Z值中位数为3.74(3.01,5.64),以右侧冠状动脉扩张为主13例(86.7%)。结论 IM伴冠状动脉扩张发生于起病后1周内,病程2~3周恢复,表现为轻度右侧冠状动脉扩张,预后良好。Objective To investigate the clinical characteristics of coronary artery dilatation （CAD） of children with infectious mononucleosis （IM）. Methods From May 2015 to December 2016, the cases diagnosed with IM in Children＇s Hospital, Capital Institute of Pediatrics were collected and performed echocardiogram. Z value was used to estimate CAD. The clinical characteristics of IM with CAD were analyzed. Results ①Clinical features： 15 children （8 boys and 7 girls） of IM with CAD among totally 344 patients were included in this study. The incidence of IM with CAD was about 4.4%. The mean age was （3.47±＋1.61） years. The most common clinical manifestation included fever （15 cases, 100.0%）, and lymph nodes enlargement （14 cases, 93.3%）. Blood routine showed leukocytosis （14 cases, 93.3%）, high lymphocyte proportion （15 cases, 100.0%） and increased atypical lymphocyte ratio （14 cases, 93.3%）. The disorder of cell-mediated immunity was found in 14 cases （93.3%）. ②Coronary artery： the median time of CAD was 5 （4, 8） d. The median duration of CAD was 17 （7, 41） d. The median Z-score of coronary artery was 3.74 （3.01, 5.64）. The right CAD was found in 13 cases （86.7%）. Conclusion CAD in patients with IM can develop within I week after onset, and persist for about 2-3 weeks. The right CAD is the most common finding, and the prognosis is good.

关 键 词：传染性单核细胞增多症 EB病毒 感染 冠状动脉 

分 类 号：R729[医药卫生—儿科]