传染性单核细胞增多症患儿抗病毒治疗的相关因素  

A retrospective study of antiviral therapy in hospitalized children with infectious mononueleosis

作　　者：庄洁新 姜曼[2] 邓继岿[1,2] Zhuang Jiexin;Jiang Man;Deng Jikui(Medical College of Shantou University,Shantou 515063,China;Department of Infectious Diseases of Shenzhen Children’s Hospital,Shenzhen 518038,China)

机构地区：[1]汕头大学医学院,汕头515063 [2]深圳市儿童医院感染科,深圳518034

出　　处：《中华实验和临床病毒学杂志》2023年第5期543-547,共5页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨抗病毒治疗对传染性单核细胞增多症(infectious mononucleosis,IM)住院患儿的疗效及选择与否的影响因素。方法将2017年1月至2021年12月深圳市儿童医院住院的IM患儿,分成阿昔洛韦(ACV)治疗组和非抗病毒治疗组,收集临床资料进行回顾性分析。结果共纳入370例患儿,年龄中位3.6岁,各年龄段占比:<3岁(25.9%)、3岁~<6岁(53.0%)、6岁~<10岁(17.6%)和≥10岁(3.5%),男∶女=1.5∶1。370名患儿中42.4%(157/370)接受ACV治疗,57.6%(213/370)未接受抗病毒治疗;感染科收治52例,均未接受抗病毒治疗,非感染科收治318例,其中157例为ACV组,两者比较有显著差异(P<0.001);非感染科患儿中38例合并肝功能异常,其中23例(60.5%)为ACV组,15例(39.5%)为非抗病毒治疗组,两者比较无显著性差异(P=0.060)。与非抗病毒治疗组相比,ACV组患儿的住院天数更长、住院费用更高(P<0.001),发热持续时间无显著差异(P>0.05),ACV组患儿的异型淋巴细胞数恢复得更快(P=0.001)。结论IM住院儿童以男童为主,3~6岁多见,接受ACV治疗并不能缩短IM患儿发热持续时间及住院天数,也不能减轻住院费用。感染专科医生更倾向于不使用抗病毒药物,肝功能异常不影响抗病毒治疗的决策。倡议减少对IM使用抗病毒药物。Objective To investigate the efficacy of antiviral therapy and its selection in hospitalized children with infectious mononucleosis(IM).Methods The IM children admitted to Shenzhen Children’s Hospital from January 2017 to December 2021 were divided into acyclovir(ACV)treatment group and non-antiviral treatment group,and the clinical data were collected for retrospective analysis.Results A total of 370 children were included,the median age was 3.6 years,each age group proportion:<3 years(25.9%),3-<6 years(53.0%).6-<10 years(17.6%)and≥10 years(3.5%).Male∶Female=1.5∶1.While 42.4%(157/370)of the 370 children received ACV,57.6%(213/370)did not receive antiviral therapy;52 cases were treated in infectious disease department,and none of them received antiviral treatment,and 318 cases were treated in non-infectious disease department,of which 157 cases were in ACV group.There was significant difference between the two groups(P<0.001);Thirty-eight cases of children in non-infectious disease department complicated with abnormal liver function,of which 23 cases(60.5%)were in the ACV group and 15 cases(39.5%)were in the non-antiviral treatment group.There was no significant difference between the two groups(P=0.060).Compared with the non-antiviral treatment group,the ACV group has longer hospitalization days and higher hospitalization expenses(P<0.01).There was no significant difference in duration of fever(P>0.05).The number of atypical lymphocytes recovered faster in ACV group(P=0.001).Conclusions The hospitalized children with IM were mostly boys,and most of them were from 3 to 6 years old.ACV treatment could not shorten the duration of fever and hospitalization days of IM children,nor could it reduce the hospitalization expenses.Abnormal liver function did not affect the decision of antiviral treatment,and infectious disease specialists prefer not to use antiviral drugs.The authors advocate reducing the use of antiviral drugs for IM.

关 键 词：儿童 抗病毒治疗 阿昔洛韦 肝功能 异型淋巴细胞 

分 类 号：R725.1[医药卫生—儿科]