传染性单核细胞增多症患儿60例临床观察
Clinical observation of 60 different age children with infectious mononucleosis
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摘要: 目的：观察不同年龄段传染性单核细胞增多症（infectious mononucleosis，IM）患儿的临床表现、实验室检查及肝损害的临床特点。方法：选择60例IM患儿作为研究对象，按照患儿年龄段分为<6岁组和≥ 6岁组，各30例。制定统一的临床和实验室观察指标，比较2组患儿主要症状及体征、实验室检查结果、并发症发生率。比较丙氨酸氨基转移酶（ALT）与患儿热程、年龄的关系。结果：2组IM患儿出现不同程度的症状及体征，<6岁患儿组与≥ 6岁患儿组在发热持续时间、最高体温等方面差异无统计学意义（P>0.05）。发热持续时间均在3~31 d，最高体温在37.5~40.1℃范围内。60例IM患儿中发热54例（90.00%），淋巴结肿大47例（78.33%），皮疹10例（16.67%），咽峡炎患儿40例（66.67%）。<6岁患儿组在脾大、肝大症状上发生率较高，与≥ 6岁患儿组相比差异有统计学意义（P<0.01）。2组患儿在白细胞、异型淋巴细胞、淋巴细胞比例三项指标方面差异均无统计学意义（P>0.05）。<6岁组患儿中代表肝功能的ALT、天冬氨酸氨基转移酶水平均较≥ 6岁组患儿低（P<0.05）。2组IM患儿出现不同程度的并发症，包括肝功能损害、肺炎、心肌损害、贫血、血小板减少、中性粒细胞减少，其中出现肝功能损害47例（78.33%）。且2组患儿在肝功能损害方面差异有统计学意义（P<0.05），在其他并发症方面差异无统计学意义（P>0.05）。ALT水平与患儿热程相关，发热时间越长，ALT异常率越高，肝损害程度越大。患儿年龄在ALT异常水平方面差异无统计学意义（P>0.05）。结论：不同年龄段的IM患儿临床表现、实验室检查、并发症方面具有一定差异性，最为常见的并发症为肝功能损害且常发生于年龄较大的儿童。
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关键词:
- 传染性单核细胞增多症 /
- EB病毒 /
- 肝损害 /
- 实验室检查 /
- 儿童
Abstract: Objective:To investigate the clinical manifestations,laboratory examination and clinical features of liver damage in different age children with infectious mononucleosis(IM).Methods:Sixty IM children were divided into the age less than 6-year-old group and age more than or equal to 6-year-old group according to the average age of children(30 cases each group).The main symptoms and signs,laboratory test results and incidence rate of complications between two groups were compared using the unified clinical and laboratory indicators.The relationships between alanine aminotransferase(ALT)level and fever duration and children age in two groups were analyzed.Results:The varying degrees of symptoms and signs in two groups were found.The duration of feve and highest temperature in two groups were 3 to 31 d and 37.5 to 40.1℃,respectively,and the differences of those were not statistically significant(P>0.05).Among 60 cases,fever in 54 cases(90.00%),lymphadenopathy in 47 cases(78.33%),rash in 10 cases(16.67%) and angina in 40 cases(66.67%) were identified.The incidence rates of splenomegaly and hepatomegaly in age <6-year-old children group were higher,and the differences of those between two groups were statistically significant(P<0.05).The differences of the proportions of white blood cells,atypical lymphocytes and lymphocytes between two groups were not statistically significant(P>0.05).The levels of ALT and aspartate aminotransferase in age < 6-year-old children group were lower than those in age more than or equal to 6-year-old group(P<0.05).The varying degrees of complications(including liver damage,pneumonia,myocardial damage,anemia,thrombocytopenia and neutropenia) in two groups were found.Forty-seven cases with liver function demage(78.33%) in two groups were found,and the difference of which between two groups was statistically significant(P<0.05),the differences of other complications between two groups were not statistically significant(P>0.05).The ALT level was correlated with the duration of fever,and the longer the fever time and higher the abnormal rate,the degree of liver damage was the greater.The difference of the abnormal level of ALT in different age children was not statistically different(P>0.05).Conclusions:The clinical manifestations,laboratory tests and complication in differnent age IM children exist differences,and the liver dysfunction is the most common complication.Hepatosplenomegaly is common in preschool children,and liver dysfunction is common in older children.-
Key words:
- infectious mononucleosis /
- EB virus /
- liver damage /
- laboratory test /
- child
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