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目的通过对成人传染性单核细胞增多症患者的临床表现、实验室特征、治疗及转归等总结疾病特点,进一步指导临床诊疗。方法对内蒙古医科大学附属医院2014年2月—2017年2月诊治住院的36例患者详尽资料进行回顾性分析。结果本组36例患者以青年为主,平均年龄在31岁,主要症状包括发热36例(100.0%)、乏力25例(69.4%)、咽痛19例(52.8%);主要体征为浅表淋巴结肿大32例(88.9%)、脾大24例(66.7%)、皮疹16例(44.4%)、扁桃体肿大14例(38.9%)、肝肿大12例(33.3%)。实验室检查结果为外周血白细胞>10×10~9/L 33例(91.7%),淋巴细胞比例高于正常34例(94.4%),外周血异型淋巴细胞>10%36例(100.0%);肝功能异常者28例(77.8%);EB病毒检测抗核衣壳抗原IgM阳性32例(88.9%)、抗核衣壳抗原IgG阳性34例(94.4%)、EBV-DNA阳性30例(83.3%)。治疗以抗病毒、肾上腺糖皮质激素及对症支持为主。结论成人传染性单核细胞增多症患者多见于青年人群,临床表现多种多样,发热持续时间长,疾病早期容易误诊,在发病早期检测抗核衣壳抗原IgM阳性、抗核衣壳抗原IgG阳性、EBV-DNA及淋巴细胞、外周血异型淋巴细胞对早期诊断具有重要价值。
Objective To further guide clinical diagnosis and treatment by summarizing the clinical features, laboratory characteristics, treatment and prognosis of adult infectious mononucleosis patients. Methods A retrospective analysis was performed on the detailed data of 36 patients who were hospitalized and treated in the Affiliated Hospital of Inner Mongolia Medical University from February 2014 to February 2017. Results The main group of 36 patients were young. The average age was 31 years old. The main symptoms were fever in 36 cases (100.0%), fatigue in 25 cases (69.4%) and sore throat in 19 cases (52.8%). The main symptoms were superficial 32 cases (88.9%) had swollen lymph nodes, 24 cases (66.7%) had splenomegaly, 16 cases (44.4%) had rash, 14 cases (38.9%) had enlarged tonsils and 12 cases (33.3%) had hepatomegaly. The results of laboratory tests showed that peripheral blood leukocytes> 10 × 10 ~ 9 / L in 33 cases (91.7%), lymphocytes in 34 cases (94.4%), peripheral blood lymphocytes> 10% in 36 cases 28 cases (77.8%) had abnormal hepatic function; 32 cases (88.9%) were positive for anti-nucleocapsid antigen (IgM) detected by Epstein-Barr virus, 34 cases were anti-nuclear capsid antigen IgG 83.3%). Treatment with anti-virus, adrenal glucocorticoid and symptomatic support based. Conclusions Adult infectious mononucleosis patients are more common in young people, with various clinical manifestations, long duration of fever, early misdiagnosis of the disease, early detection of anti-nuclear capsid antigens IgM positive anti-nuclear capsid antigens IgG positive , EBV-DNA and lymphocytes, peripheral blood lymphocytes are of great value in the early diagnosis.