中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
31期
32-34
,共3页
张东兰%王淑香%张志刚%翟德翠
張東蘭%王淑香%張誌剛%翟德翠
장동란%왕숙향%장지강%적덕취
传染性单核细胞增多症%危险因素%Logistic模型%肝损害
傳染性單覈細胞增多癥%危險因素%Logistic模型%肝損害
전염성단핵세포증다증%위험인소%Logistic모형%간손해
Infectious mononucleosis%Risk factors%Logisitic models%Liver damage
目的 探讨传染性单核细胞增多症(IM)并发肝损害的相关因素,为IM并发肝损害发生的防治提供参考.方法 共纳入175例IM儿童患者,按照其是否发生肝损害分为两组,其中85例并发肝损害为病例组,90例未并发肝损害为对照组,应用非条件Logistic回归进行单因素及多因素分析.结果 单因素分析结果表明:两组间年龄≥6岁、男性、病程、病情(累及器官≥2个)、发热时间、最高体温、白细胞(WBC)、C反应蛋白(CRP)、CD4+、CD8+、CD4+/CD8+、EB病毒-衣壳抗原EBV-CA-IgM抗体阳性及红细胞沉降率增快比较差异有统计学意义(P＜0.05),其中年龄≥6岁、男性、病程、病情(累及器官≥2个)、发热时间、最高体温、WBC、CRP、CD8+、抗EBV-CA-IgM抗体阳性及红细胞沉降率增快与IM并发肝损害呈正相关,而CD4+、CD4+/CD8+与IM并发肝损害呈负相关.进一步行多因素分析结果表明:病情(累及器官≥2个)、CD8+高为IM并发肝损害的独立危险因素,而CD4+高、CD4+/CD8+高为IM并发肝损害的保护因素(P＜0.05).结论 病情(累及器官≥2个)、CD8+高为IM并发肝损害的独立危险因素,而CD4+高、CD4+/CD8+高为IM并发肝损害的保护因素,因此在临床工作中,积极抗病毒治疗的同时,可以使用免疫调节剂等对上述因素进行必要的干预.
目的 探討傳染性單覈細胞增多癥(IM)併髮肝損害的相關因素,為IM併髮肝損害髮生的防治提供參攷.方法 共納入175例IM兒童患者,按照其是否髮生肝損害分為兩組,其中85例併髮肝損害為病例組,90例未併髮肝損害為對照組,應用非條件Logistic迴歸進行單因素及多因素分析.結果 單因素分析結果錶明:兩組間年齡≥6歲、男性、病程、病情(纍及器官≥2箇)、髮熱時間、最高體溫、白細胞(WBC)、C反應蛋白(CRP)、CD4+、CD8+、CD4+/CD8+、EB病毒-衣殼抗原EBV-CA-IgM抗體暘性及紅細胞沉降率增快比較差異有統計學意義(P＜0.05),其中年齡≥6歲、男性、病程、病情(纍及器官≥2箇)、髮熱時間、最高體溫、WBC、CRP、CD8+、抗EBV-CA-IgM抗體暘性及紅細胞沉降率增快與IM併髮肝損害呈正相關,而CD4+、CD4+/CD8+與IM併髮肝損害呈負相關.進一步行多因素分析結果錶明:病情(纍及器官≥2箇)、CD8+高為IM併髮肝損害的獨立危險因素,而CD4+高、CD4+/CD8+高為IM併髮肝損害的保護因素(P＜0.05).結論 病情(纍及器官≥2箇)、CD8+高為IM併髮肝損害的獨立危險因素,而CD4+高、CD4+/CD8+高為IM併髮肝損害的保護因素,因此在臨床工作中,積極抗病毒治療的同時,可以使用免疫調節劑等對上述因素進行必要的榦預.
목적 탐토전염성단핵세포증다증(IM)병발간손해적상관인소,위IM병발간손해발생적방치제공삼고.방법 공납입175례IM인동환자,안조기시부발생간손해분위량조,기중85례병발간손해위병례조,90례미병발간손해위대조조,응용비조건Logistic회귀진행단인소급다인소분석.결과 단인소분석결과표명:량조간년령≥6세、남성、병정、병정(루급기관≥2개)、발열시간、최고체온、백세포(WBC)、C반응단백(CRP)、CD4+、CD8+、CD4+/CD8+、EB병독-의각항원EBV-CA-IgM항체양성급홍세포침강솔증쾌비교차이유통계학의의(P＜0.05),기중년령≥6세、남성、병정、병정(루급기관≥2개)、발열시간、최고체온、WBC、CRP、CD8+、항EBV-CA-IgM항체양성급홍세포침강솔증쾌여IM병발간손해정정상관,이CD4+、CD4+/CD8+여IM병발간손해정부상관.진일보행다인소분석결과표명:병정(루급기관≥2개)、CD8+고위IM병발간손해적독립위험인소,이CD4+고、CD4+/CD8+고위IM병발간손해적보호인소(P＜0.05).결론 병정(루급기관≥2개)、CD8+고위IM병발간손해적독립위험인소,이CD4+고、CD4+/CD8+고위IM병발간손해적보호인소,인차재림상공작중,적겁항병독치료적동시,가이사용면역조절제등대상술인소진행필요적간예.
Objective To investigate the correlation factors of liver injury in infectious mononucleosis(IM).Methods One hundred and seventy-five IM patients were divided into two groups:IM with liver injury(patient group,85 cases)and IM without liver injury(control group,90 cases).Single factor and multiple factor analysis were completed by unconditional Logistic regression.Results Single factor analysis results showed that there were significance differences between the two groups in age(≥6 years old),male,course of disease,severe disease(involving ≥ 2 organs),heating time,the peak temperature,white blood cell(WBC)and C reactive protein(CRP),CD4+,CD8+,CD4+/CD8+,Epstein-Barr virus(EBV)-capsid antigen(CA)-IgM antibody positive and increased erythrocyte sedimentation rate(ESR)(P＜0.05).Age(≥ 6 years old),male,course of disease,severe disease(involving ≥2 organs),heating time,the peak temperature,WBC,CRP,CD8+,EBV-CA-IgM antibody positive and increased ESR showed positive correlation with IM combined with liver injury,and CD4+,CD4+/CD8+ showed negatively correlated with IM combined with liver injury.Multiple factor analysis results showed that severe disease(involving ≥2 organs),CD8+ high levels were independent risk factors for IM combined with liver injury,and CD4+ high levels and CD4+/CD8+ high were protection factors for IM combined with liver injury(P＜0.05).Conclusions Severe disease(involving ≥2 organs),CD8+ high levels are independent risk factors for IM combined with liver injury,and CD4+ high levels and CD4+/CD8+ high are protection factors for IM combined with liver injury.Therefore,immune modulators should be used to intervene the above factors when patients are treated with antiviral drugs.
