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目的分析儿童EB病毒(Epstein-Barr virus,EBV)感染传染性单核细胞增多症(infectious mononucleosis,IM)的临床特征。方法回顾性分析南昌市第三医院儿科2006年1月至2011年3月符合EBV感染IM诊断标准的118例患儿的临床症状、体征、实验室检查及治疗转归。结果 118例患儿,其中男66例(55.93%),女52例(44.07%)。发热、咽炎、扁桃体炎、颈部淋巴结肿大、肝脾肿大等是IM患儿的主要临床表现,其中发热102例(86.44%),咽炎、扁桃体炎98例(83.05%),颈部淋巴结肿大93例(78.81%),肝脏肿大35例(29.66%),脾脏肿大29例(24.58%),皮疹42例(35.59%),双眼睑水肿12例(10.17%),外周血白细胞>10×10997例(82.20%),其中>20×10929例(24.58%),异形淋巴细胞10%～20%96例(81.36%),异形淋巴细胞>20%22例(18.64%),肝功能异常51例(43.22%),心肌酶谱异常36例(30.51%),血沉增快35例(29.66%)。结论 IM的临床表现多样,可累及全身多器官、多系统。对于急性起病、有发热、咽痛、淋巴结或肝脾肿大、皮疹、双眼睑水肿等症状者,须高度考虑IM,需进一步行相关检查。早期诊断,及时治疗,预后良好。
Objective To analyze the clinical features of Epstein-Barr virus (EBV) infection in infectious mononucleosis (IM). Methods A retrospective analysis of clinical symptoms, signs, laboratory tests and treatment outcomes of 118 children with pediatric EBV infection in pediatrics of the Third Hospital of Nanchang from January 2006 to March 2011 was performed. Results 118 cases of children, including 66 males (55.93%), 52 females (44.07%). Fever, pharyngitis, tonsillitis, cervical lymphadenopathy, hepatosplenomegaly were the main clinical manifestations in children with IM, including 102 cases of fever (86.44%), pharyngitis and tonsillitis in 98 cases (83.05%), cervical lymph nodes 93 cases (78.81%) were swollen, 35 cases (29.66%) had liver enlargement, 29 cases (24.58%) had swollen spleen, 42 cases (35.59%) had rash, 12 cases (10.17%) had double eyelid edema, > 20 10929 cases (24.58%), 10% ~ 20% 96 cases (81.36%) of allogeneic lymphocytes, 22 cases (18.64%) of allogeneic lymphocytes> 20%, liver Fifty-one patients (43.22%) had abnormal function, 36 (30.51%) had abnormal myocardial enzymes and 35 (29.66%) had erythrocyte sedimentation rate. Conclusion The clinical manifestations of IM are diverse and can affect whole body multiple organs and multiple systems. For acute onset, fever, sore throat, lymph nodes or hepatosplenomegaly, rash, double eyelid edema and other symptoms, to be highly considered IM, the need for further related inspection. Early diagnosis, timely treatment, the prognosis is good.