原发性EB病毒感染患儿的临床和实验室检查特征分析  

Clinical and laboratory characteristics of primary Epstein-Barr virus infection in children

作　　者：沈军[1] 曹凌峰[2] 施鹏[3] 蔡启良 俞蕙[1] Shen Jun;Cao Lingfeng;Shi Peng;Cai Qiliang;Yu Hui(Department of Infectious Diseases,Children's Hospital of Fudan University,Shanghai 201102,China;Department of Virology,Children's Hospital of Fudan University,Shanghai 201102,China;Information Center,Children's Hospital of Fudan University,Shanghai 201102,China;Laboratory of Medical Molecular Virology(Ministries of Education and Health),School of Basic Medical Science,Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院感染科,上海201102 [2]复旦大学附属儿科医院病毒实验室,上海201102 [3]复旦大学附属儿科医院信息中心,上海201102 [4]复旦大学基础医学院教育部/卫生健康委员会医学分子病毒学重点实验室,上海201102

出　　处：《中华传染病杂志》2020年第5期279-282,共4页Chinese Journal of Infectious Diseases

基　　金：上海市公共卫生重点学科建设项目(08GWZX0102);上海市卫生和计划生育委员会面上项目(201840282)。

摘　　要：目的:了解原发性EB病毒感染患儿的临床和实验室检查特征。方法:回顾性分析2016年9月至2017年3月上海复旦大学附属儿科医院感染科诊治的210例原发性EB病毒感染患儿的临床特征(发热、皮疹等)及相关实验室检查结果(包括肝功能、EB病毒血清学及分子生物学)。结果:210例原发性EB病毒感染患儿的年龄为(4.2±2.4)岁。发热187例(89.0%),扁桃体和(或)咽峡部渗出130例(61.9%),颈部淋巴结肿大204例(97.1%),眼睑水肿95例(45.2%),皮疹21例(10.0%),120例(57.1%)患儿有传染性单核细胞增多症典型三联症(发热、咽扁桃体炎和颈部淋巴结肿大)表现。实验室检查结果显示,177例(84.3%)患儿淋巴细胞计数≥5.0×10^9/L,184例(87.6%)患儿异型淋巴细胞比例≥0.10。96例(45.7%)患儿转氨酶升高,对72例患儿随访至转氨酶恢复正常,6周内恢复正常占97.2%(70/72)。EB病毒衣壳抗原IgM抗体阳性192例(91.4%),EB病毒衣壳抗原IgG抗体阳性182例(86.7%),EB病毒早期抗原IgG抗体阳性62例(29.5%),EB病毒核心抗原IgG抗体均为阴性。199例患儿完成EB病毒DNA检测,阳性122例(61.3%)。结论:原发性EB病毒感染以学龄前儿童为主,大部分患儿有颈部淋巴结肿大伴发热,且EB病毒血清学指标阳性,部分患儿出现转氨酶一过性升高。Objective To understand the clinical and laboratory characteristics of primary Epstein-Barr virus(EBV)infection in children.Methods Totally 210 cases with primary EBV infection from September 2016 to March 2017 in Department of Infectious Diseases,Children's Hospital of Fudan University in Shanghai were retrospectively collected.The clinical information(fever,rash,etc),and laboratory data such as liver function,EBV test(serological test,polymerase chain reaction(PCR)-DNA)were analyzed.Results The age of children with primary EBV infection was(4.2±2.4)years.Numbers of patients with fever,tonsil and/or pharynx exudation,cervical lymphadenopathy,eyelid edema and rash were 187(89.0%),130(61.9%),204(97.1%),95(45.2%)and 21(10.0%),respectively.A total of 120 cases(57.1%)presented with typical triplets of infectious mononucleosis.Absolute lymphocyte count≥5.0×10^9/L was found in 177 cases(84.3%),and abnormal lymphocyte ratio≥0.10 was found in 184 cases(87.6%).Elevated transaminase level was found in 96 cases(45.6%),and 72 cases were followed until transaminase level back to normal,in whom 97.2%(70/72)patient returned to normal within six weeks.Epstein-Barr viral capsid antigen(EBV-VCA)-IgM was positive in 192 cases(91.4%).EBV-VCA-IgG and Epstein-Barr viral early antigen(EBV-EA)-IgG positive were presented in 182 cases(86.7%)and 62 cases(29.5%),respectively.Epstein-Barr viral nuclear antigen(EBV-NA)-IgG was negative in all cases.EBV DNA test was carried in 199 cases,of which 122 cases(61.3%)were positive.Conclusions Pediatric primary EBV infection mainly occurs in preschoolers.Most patients are presented with enlarged cervical lymph nodes,fever,and positive EBV serological markers.Transient transaminase elevation is observed in some cases.

关 键 词：EB病毒 原发性感染 儿童 

分 类 号：R512.7[医药卫生—内科学]