中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
18期
8209-8212
,共4页
疱疹病毒4型,人%传染性单核细胞增多症%临床特征
皰疹病毒4型,人%傳染性單覈細胞增多癥%臨床特徵
포진병독4형,인%전염성단핵세포증다증%림상특정
Herpesvirus 4,human%Infectious mononucleosis%Clinical features
目的：探讨儿童EB病毒（EBV）感染传染性单核细胞增多症（IM）的临床特征，以提高临床诊断水平。方法收集2012年1～12月南京医科大学附属南京儿童医院收治符合EBV感染IM诊断标准的102例患儿，将102例EBV-IM患儿分成＜3岁、3～6岁、≥7岁3组，对这三组临床资料进行回顾性分析。结果102例中，男女比例1.3∶1；＜3岁35例（34.3%），3～6岁46例（45.1%），≥7岁21例（20.6%）。临床表现多种多样，其中发热、咽峡炎和淋巴结肿大是 IM 患儿的主要临床表现，其阳性率分别为100%、93.1%和75.5%；肝大、脾大、皮疹和眼睑水肿的发生率分别为45.1%、37.3%、30.4%和16.7%，以上临床表现在三个年龄组之间差异无统计学意义（P＞0.05）。外周血白细胞年幼儿升高明显，异型淋巴细胞各年龄组无明显差异，血清ALT、AST在年长儿偏高。结论 EBV-IM起病症状多样，可累及全身多个系统，结合临床表现及检测EBV-DNA、EBV抗体有助于早期诊断。
目的：探討兒童EB病毒（EBV）感染傳染性單覈細胞增多癥（IM）的臨床特徵，以提高臨床診斷水平。方法收集2012年1～12月南京醫科大學附屬南京兒童醫院收治符閤EBV感染IM診斷標準的102例患兒，將102例EBV-IM患兒分成＜3歲、3～6歲、≥7歲3組，對這三組臨床資料進行迴顧性分析。結果102例中，男女比例1.3∶1；＜3歲35例（34.3%），3～6歲46例（45.1%），≥7歲21例（20.6%）。臨床錶現多種多樣，其中髮熱、嚥峽炎和淋巴結腫大是 IM 患兒的主要臨床錶現，其暘性率分彆為100%、93.1%和75.5%；肝大、脾大、皮疹和眼瞼水腫的髮生率分彆為45.1%、37.3%、30.4%和16.7%，以上臨床錶現在三箇年齡組之間差異無統計學意義（P＞0.05）。外週血白細胞年幼兒升高明顯，異型淋巴細胞各年齡組無明顯差異，血清ALT、AST在年長兒偏高。結論 EBV-IM起病癥狀多樣，可纍及全身多箇繫統，結閤臨床錶現及檢測EBV-DNA、EBV抗體有助于早期診斷。
목적：탐토인동EB병독（EBV）감염전염성단핵세포증다증（IM）적림상특정，이제고림상진단수평。방법수집2012년1～12월남경의과대학부속남경인동의원수치부합EBV감염IM진단표준적102례환인，장102례EBV-IM환인분성＜3세、3～6세、≥7세3조，대저삼조림상자료진행회고성분석。결과102례중，남녀비례1.3∶1；＜3세35례（34.3%），3～6세46례（45.1%），≥7세21례（20.6%）。림상표현다충다양，기중발열、인협염화림파결종대시 IM 환인적주요림상표현，기양성솔분별위100%、93.1%화75.5%；간대、비대、피진화안검수종적발생솔분별위45.1%、37.3%、30.4%화16.7%，이상림상표현재삼개년령조지간차이무통계학의의（P＞0.05）。외주혈백세포년유인승고명현，이형림파세포각년령조무명현차이，혈청ALT、AST재년장인편고。결론 EBV-IM기병증상다양，가루급전신다개계통，결합림상표현급검측EBV-DNA、EBV항체유조우조기진단。
Objective To explore the clinical features of Epstein-Barr virus(EBV)-associated infectious mononucleosis (IM) in children and improve its clinical diagnosis. Methods A retrospective study was conducted in 102 hospitalized patients with EBV-IM who were enrolled from Jan 2012 to Dec 2012 in Nanjing Children's Hospital Affiliated to Nanjing Medical University. The patients were divided into 3 age groups: <3 years, 3 to 6 years, and≥7 years. We evaluated the recent trend in clinical manifestations and the differences in clinical and laboratory findings among the 3 age groups. Results 102 cases of this group, male to female ratio 1.3∶1;the percent of <3-year-old, 3-6-year-old and ≥7-year-old was 34.3%, 45.1%, 20.6%. Fever, pharyngitis and lymphadenopathy were main manifestations of the patients with EBV-IM, these incidence rate were 100%, 93.1%and 87.7%, respectively. Incidence of splenomegaly, hepatomegaly, rash and puffy eyelid were 45.1%, 37.3%, 30.4% and 16.7%, respectively. The differences in the symptoms among the 3 age groups were not statistically significant.The atypical lymphocyte was not difference in the age groups. The leukocyte count was higher in the younger age group. A comparison of ALT, AST elevation among the age groups showed an association with advancing age(P<0.05). Conclusion The clinical features and laboratory examinations are complicated and diverse in pediatric patient with EBV-IM.The misdiagnosis and missed diagnosis could be avoided through better understanding of such disease. The diagnostic value of detection of EBV specific antibodies and EBV-DNA in serum should be emphasized.
