小儿传染性单核细胞增多症112例临床分析

摘要

目的 分析儿童传染性单核细胞增多症(简称传单)的临床特点.方法 回顾性分析我科2016年5月至2017年5月诊治的儿童传单112例临床资料.结果 传染性单核细胞增多症临床表现多样,以发热、咽峡炎、颈淋巴结肿大最常见,双眼睑浮肿(33%),肝肿大(12.5%),鼻塞(42%),各年龄组差异无统计学意义,皮疹(3.6%),各年龄组差异有统计学意义.实验室检查:变异淋≥10%(30.4%);传单肝功变化以酶学改变为主,其中以乳酸脱氢酶升高最常见;T细胞亚群检测92.5%表现CD3 +CD8 +明显增高,CD3 +CD4 +、CD3 +CD4 +/CD3 +CD8 +明显减低.EBV-VCA-IgM阳性(92.9%),EBV-DNA阳性(84.8%).结论 传染单核细胞增多症是全身性疾病,临床表现多样,绝大多数患儿预后良好,综合分析临床特点与实验室结果,可减少误诊和漏诊.%Objective To analyze the clinical characteristics of infectious mononucleosis(IM)in children.Methods We retrospectively analyzed the clinical data of 112 cases of children's IM from May 2016 to May 2017 in pediatric hospital of Sichuan Province People′s Hospital.Results Infectious mononucleosis clinical manifestations varied,with the most common fever,angina, lymphonodi cervicales swollen,and double eyelid edema(33%),liver enlargement(12.5%),nasal congestion(42%),no statisti-cal significance in different age groups,skin rash(3.6%),statistical significance of different age groups.In the laboratory examina-tion,lymphatic variation was greater than 10%and accounted for 30.4%.The change of liver function in flyers was mainly enzy-matic change,whit the most common lactic dehydrogenase.T cell subgroup were detected 92.5%expression of CD3 +CD8 +signifi-cantly higher,CD3 +CD4 +,CD3 +CD4 +/CD3 +CD8 +significantly reduced.EBV-VCA-IgM(92.9%)and EBV-DNA(84.8%) were positive.Conclusion Infectious mononucleosis is a various clinical manifestation systemic disease with good prognosis in most children.The comprehensive analysis of the clinical characteristics and the laboratory results can reduce misdiagnosis and missed diagnosis.