27例坏死性淋巴结炎临床分析及组织EBV、CMV测定  

Pathogene of EBV,CMV and Clinical Analysis of 27Cases of Necrotizing Lymphadenitis

作　　者：朱广卿[1] 李丰[1] 蔡庆[1] 彭勃[1] 肖晓光[1] 王洪海[1] 

机构地区：[1]空军总医院老年病呼吸科,北京100036

出　　处：《中国医师杂志》2003年第3期317-319,共3页Journal of Chinese Physician

摘　　要：目的　探索坏死性淋巴结炎的发病原因和发病规律。方法　临床综合分析并应用PCR方法对淋巴结组织进行了EBV、CMV的DNA扩增。结果　EBV、CMV总阳性率 60 % ,与对照组无显著性差异 (P >0 0 5 )。 2 7例中男 :女 =2 :1,81 5 %于 4～10月发病。 18例住院患者 3 8 9%发烧与淋巴结肿大同时出现 ;3 3 3 %首先出现发烧 ;白细胞减低、增高各 4例 ;11例使用糖皮质激素治疗后 1～ 17d体温正常 ;2例青霉素治疗过程中出现淋巴结肿大 ,停药当天体温正常 ,3d淋巴结消失。结论　坏死性淋巴结炎可能与病毒感染有关 ,但不是直接致病原因 ,可能是由病毒或其他因素诱发的一种变态反应性或自身免疫性疾病。部分坏死性淋巴结炎可随着致病因素的去除和 /或机体内外环境改变而自限 ,但对短期内病情不能自行好转者 ,应给予糖皮质激素治疗 ,以缩短病程。Objective To probe into the etiology and the clinical characteristics of necrotizing lymphadenitis(HL).Methods The clinical data were analyzed and polymerase chain reaction( PCR) method was used to examine DNA expression of Epstein-BARR virus(EBV) and cytomegalovirus(CMV) in lymph tissues in 25 of 27 cases.Results The results showed that the total positive rate of EBV and CMV was 60%,there was no significantly distinction between patients with HL and with lymphadenitis(χ 2=0 243,P>0 05). The patients ranged in age from 3 5 to 41 years,M:F ratio was 2:1. The disease attacked during Apr and Oct in 22 cases(81 5%).The 5 of 18 in-patients turned up fever and enlargement of lymph node at the same time, 33 3% in-patients turned up fever at first. The leucocyte decreased in 4 in-patients and increased in 4. Eleven in-patients were treated with glucocorticoids,and all of their temperature normalized from 1 to 17 days. The temperature normalization in two in-patients when they stopped using penicillin,whose lymph node enlargement during treated with penicillin,and the lymphy nodes disapearance in three days after stopped using penicillin.Conclusions There are relationship between HL and virus infection,but they are not major reason.It maybe a autoimmune disease or allergic disease induced by virus or other factors.Some of patients with HL can self-confine following the removal of the pathogene and/or the improvement of the internal environment.The patient who can not be self-cure,should be treated with glucocorticoids in order to shorten course of the disease.

关 键 词：坏死性淋巴结炎 临床分析 EBV CMV 

分 类 号：R551.2[医药卫生—血液循环系统疾病]