儿童传染性单核细胞增多症住院病例的临床和实验室特征  

Clinical and laboratory characteristics of hospitalized cases of infectious mononucleosis in children

作　　者：陈烨[1] 杨媛艳 王歆琼[1] 顾秋芳 Chen Ye;Yang Yuanyan;Wan Qinqiong;Gu Qiufang(Department of Pediatric Internal Medicine,Ruijin Hospital of Shanghai Jiaotong University,Shanghai 200020,China)

机构地区：[1]上海交通大学附属瑞金医院儿内科,200020

出　　处：《山西医药杂志》2022年第21期2411-2413,共3页Shanxi Medical Journal

摘　　要：目的探讨儿童传染性单核细胞增多症住院患儿的临床表现和肝功能等实验室检查特征,以提高对儿童原发性EB病毒(EBV)感染的认识。方法对2016年1月至2019年12月上海交通大学附属瑞金医院北院儿内科收治的血清学确诊为原发性EBV感染患儿的临床资料进行回顾性分析。结果共33例传染性单核细胞增多症患儿,包括男性18例,女性15例。临床表现为均有发热(100%),热程(5.7±2.7)d。淋巴结肿大33例(100%),咽峡炎27例(82%),肝脾肿大26例(79%),皮疹16例(48%),鼻塞32例(97%),眼睑浮肿23例(70%)。肝功能异常患儿25例(76%),均在住院期间复查了肝功能4项,结果显示天冬氨酸转氨酶和丙氨酸转氨酶治疗前后比较差异有统计学意义(P<0.05)。其中19例患儿复查了肝功能13项,通过对其他生化指标的检查对比结果显示,治疗后总胆汁酸、甘胆酸、乳酸脱氢酶较治疗前下降,前白蛋白和白蛋白较治疗前升高,差异有统计学意义(P<0.05)。结论儿童传染性单核细胞增多症常见的症状为发热、颈部淋巴结大、鼻塞、咽峡炎和肝脾肿大。肝功能损害除转氨酶升高以外,还可以合并总胆汁酸、甘胆酸、乳酸脱氢酶升高,前白蛋白和白蛋白下降,应给予关注。Objective To investigate the clinical manifestations,liver function and other laboratory features of children with infectious mononucleosis,and to improve the understanding of primary Epstein-Barr virus(EBV)infection in children.Methods The clinical data of children with primary EBV infection confirmed by serology were retrospectively analyzed in the Department of Pediatrics,North Hospital of Ruijin Affiliated Hospital of Shanghai Jiaotong University from January 2016 to December 2019.Results There were 33 children with infectious mononucleosis,including 18 males and 15 females.The clinical manifestations were fever(100%)and fever duration were(5.7±2.7)d.There were 33 cases with lymph node enlargement(100%),27 cases with pharyngitis(82%),26 cases with hepatosplenomegaly(79%),16 cases of rash(48%),32 cases with nasal obstruction(97%),23 cases with eyelid edema(70%).In 25 cases with abnormal liver function(76%),four liver functions were reexamined during hospitalization,and the results showed that there was a statistically significant difference between AST and ALT before and after treatment(P<0.05).The liver functions of thirteen cases were reexamined in 19 children,and the results of other biochemical indexes showed that total bile acid,glycolic acid and lactate dehydrogenase decreased after treatment,while pre-albumin and albumin increased with statistical significance(P<0.05).Conclusion The most common symptoms of infectious mononucleosis in children are fever,large cervical lymph nodes,nasal obstruction,pharyngitis and hepatosplenomegaly.In addition to elevated transaminases,it can also be combined with the increase of total bile acid,glycolic acid,lactate dehydrogenase rise,and the decrease of prealbumin and albumin,which should be taken into attention.

关 键 词：传染性单核细胞增多症 肝功能损害 儿童 

分 类 号：R725.1[医药卫生—儿科]