传染病信息
傳染病信息
전염병신식
INFECTIOUS DISEASE INFORMATION
2014年
1期
52-54
,共3页
传染性单核细胞增多症%EBV%肝功能%成人
傳染性單覈細胞增多癥%EBV%肝功能%成人
전염성단핵세포증다증%EBV%간공능%성인
infectious mononucleosis%EBV%liver function%adult
目的：探讨成人传染性单核细胞增多症（infectious mononucleosis, IM）的临床表现。方法回顾性分析2006年6月-2012年6月在复旦大学附属华山医院住院治疗的70例IM患者的病例资料。结果成人IM呈全年散发，患者年龄（31.4±13.9）岁，男性略多于女性。患者均有发热，其中70.0％有咽峡炎，68.6％脾大，65.7％淋巴结肿大，29.0％皮疹，15.7％肝大，11.4％头痛。血常规检查50.0％的患者白细胞升高，81.4％的患者淋巴细胞比例＞35％，42.9％的患者外周血涂片异形淋巴细胞＞30％，84.3％的患者血小板正常。92.9％的患者肝功能异常，47.1％的患者ALT＞5倍正常值上限（upper limit of normal, ULN），但仅有8.6％的患者TBIL＞2×ULN。1例出现肾功能异常。血清学检测EBV IgM阳性率为50.0％，EBV IgG阳性率为91.7％。 EBV DNA载量中位数为4.1 log10 copies/ml。患者住院天数（11.6±6.8） d。2例慢性活动性EBV感染者死亡，治愈率为92.9％。结论 IM为自限性疾病，不必常规应用糖皮质激素和抗病毒药物，且预后良好，但慢性活动性EBV感染者预后差。
目的：探討成人傳染性單覈細胞增多癥（infectious mononucleosis, IM）的臨床錶現。方法迴顧性分析2006年6月-2012年6月在複旦大學附屬華山醫院住院治療的70例IM患者的病例資料。結果成人IM呈全年散髮，患者年齡（31.4±13.9）歲，男性略多于女性。患者均有髮熱，其中70.0％有嚥峽炎，68.6％脾大，65.7％淋巴結腫大，29.0％皮疹，15.7％肝大，11.4％頭痛。血常規檢查50.0％的患者白細胞升高，81.4％的患者淋巴細胞比例＞35％，42.9％的患者外週血塗片異形淋巴細胞＞30％，84.3％的患者血小闆正常。92.9％的患者肝功能異常，47.1％的患者ALT＞5倍正常值上限（upper limit of normal, ULN），但僅有8.6％的患者TBIL＞2×ULN。1例齣現腎功能異常。血清學檢測EBV IgM暘性率為50.0％，EBV IgG暘性率為91.7％。 EBV DNA載量中位數為4.1 log10 copies/ml。患者住院天數（11.6±6.8） d。2例慢性活動性EBV感染者死亡，治愈率為92.9％。結論 IM為自限性疾病，不必常規應用糖皮質激素和抗病毒藥物，且預後良好，但慢性活動性EBV感染者預後差。
목적：탐토성인전염성단핵세포증다증（infectious mononucleosis, IM）적림상표현。방법회고성분석2006년6월-2012년6월재복단대학부속화산의원주원치료적70례IM환자적병례자료。결과성인IM정전년산발，환자년령（31.4±13.9）세，남성략다우녀성。환자균유발열，기중70.0％유인협염，68.6％비대，65.7％림파결종대，29.0％피진，15.7％간대，11.4％두통。혈상규검사50.0％적환자백세포승고，81.4％적환자림파세포비례＞35％，42.9％적환자외주혈도편이형림파세포＞30％，84.3％적환자혈소판정상。92.9％적환자간공능이상，47.1％적환자ALT＞5배정상치상한（upper limit of normal, ULN），단부유8.6％적환자TBIL＞2×ULN。1례출현신공능이상。혈청학검측EBV IgM양성솔위50.0％，EBV IgG양성솔위91.7％。 EBV DNA재량중위수위4.1 log10 copies/ml。환자주원천수（11.6±6.8） d。2례만성활동성EBV감염자사망，치유솔위92.9％。결론 IM위자한성질병，불필상규응용당피질격소화항병독약물，차예후량호，단만성활동성EBV감염자예후차。
Objective To investigare the clinical features of infectious mononucleosis (IM) in adult patients. Methods The clinical data of 70 adult patients with IM, who were hospitalized in Huashan Hospital Affiliated to Fudan University, from Jun. 2006 to Jun. 2012, were analyzed retrospectively. Results IM could occur in adults during the whole year. The average age of the patients was 31.4±13.9 years old, and male patients were slightly more than female patients. All the patients had fever, while 70.0% of them had agina, 68.6% splenomegaly, 65.7% lymph node enlargement, 29.0% skin rash,15.7% hepatomegaly and 11.4% headache. WBC increased in 50.0% of the patients, the proportion of lymphocytes was more than 35% in 81.4% of the patients, the proportion of atypical lymphocytes was more than 30% in 42.9% of the patients, and PLT were normal in 84.3% of the patients. Liver function was abnormal in 92.9% of the patients. ALT level was above 5 times upper normal limit (ULN) in 47.1% of the patients, but TBIL was above 2 times ULN only in 8.6% of the patients. One patient had abnormal renal function. Epstein-Barr virus (EBV) IgM was positive in 50.0% of the patients and EBV IgG was positive in 91.7% of the patients. The median EBV DNA load was 4.1 log 10 copies/ml. The average hospitalization days were 11.6 ±6.8 days. Two patients with chronic active EBV infection were died, and the curative rate was 92.9%. Conclusions IM is a self-limiting disease, and is no need using corticosteroid or antiviral drugs as a rou-tine treatment. Generally, the prognosis of IM is good, but prognosis of chronic active EBV infection is poor.
