儿童传染性单核细胞增多症病例特点分析  

Analysis of case characteristics of infectious mononucleosis in children

作　　者：赵薇[1] 徐之良[1] Zhao Wei;Xu Zhiliang(Department of Pediatrics,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院儿科,武汉430060

出　　处：《中国医学前沿杂志（电子版）》2021年第8期63-66,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究儿童EB病毒(Epstein-Barr virus,EBV)感染所致传染性单核细胞增多症(infectious mononucleosis,IM)的病例特点和治疗方案。方法回顾性分析2018年1月至2018年12月于武汉大学人民医院诊断为IM的132例患儿的临床资料,并总结IM患儿的临床特点和治疗方案。结果 132例患儿中,男84例,女48例,男女比例为1.75∶1.00;发病年龄以3~6岁多见;春夏季为发病高峰;主要临床表现为发热(132/132)、咽峡炎(132/132)、淋巴结肿大(121/132)、严重鼻塞(96/132)、眼睑浮肿(82/132)、脾大(88/132)、肝大(57/132)、不典型皮疹(32/132);合并症以肺炎(38/132)和中性粒细胞减少(49/132)为主;抗衣壳抗原免疫球蛋白M的阳性率为100%,EBV-DNA拷贝数增高108例,淋巴细胞计数≥5.0×10^(9)/L 98例,谷丙转氨酶升高90例。69例患儿使用糖皮质激素治疗,86例患儿使用更昔洛韦治疗,预后均良好,无严重并发症发生。结论 IM的临床表现多样,以发热和咽峡炎最常见,确诊该病应行EBV抗体检测,是否使用抗病毒药物治疗仍存在争议,激素治疗亦需谨慎,但该病一般预后良好。Objective To explore the case characteristics and treatment plans of infectious mononucleosis(IM)caused by Epstein-Barr virus(EBV)infection in children.Method The clinical data of 132 children diagnosed with IM from January 2018 to December 2018 in Renmin Hospital of Wuhan University were retrospectively analyzed,and their clinical characteristics and treatment plans were summarized.Result Among the 132 children,84 cases were males and 48 cases were females,with a male-to-female ratio of 1.75∶1.00;the age of onset was mainly 3~6 years old;the peak incidence was in spring and summer;the main clinical manifestations were fever(132/132),angina(132/132),lymph node tumefaction(121/132),severe nasal obstruction(96/132),eyelid edema(82/132),splenomegaly(88/132),hepatomegaly(57/132),atypical skin rash(32/132);complications were mainly pneumonia(38/132)and neutropenia(49/132);the positive rate of anti-capsid antigen immunoglobulin M was 100%,EBV-DNA copy number increased in 108 cases,lymphocyte count≥5.0×10^(9)/L in 98 cases,alanine aminotransferase increased in 90 cases.Sixty-nine children were treated with glucocorticoids and 86 children were treated with ganciclovir.Conclusion The clinical manifestations of IM are diverse.Fever and angina are the most common manifestations.The diagnosis of the disease should be tested for EBV antibodies.The use of antiviral drugs is still controversial,and hormone therapy also needs to be cautious,but the disease generally has a good prognosis.

关 键 词：EB病毒感染 传染性单核细胞增多症 临床特点 诊断 治疗效果 

分 类 号：R725.1[医药卫生—儿科]