中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
21期
3317-3320
,共4页
传染性单核细胞增多症%EB 病毒%肺炎支原体%临床特征%儿童
傳染性單覈細胞增多癥%EB 病毒%肺炎支原體%臨床特徵%兒童
전염성단핵세포증다증%EB 병독%폐염지원체%림상특정%인동
Infectious Mononucleosis%Epstein -Barr virus%Mycoplasma pneumoniae%Clinical characteris-tics%Children
目的：探讨儿童 EB 病毒（EBV）合并肺炎支原体（MP）感染传染性单核细胞增多症（传单）的临床特征。方法选择 EBV 检测阳性的传单患儿，按照 MP 检测结果分为 EBV ＋MP 组和 EBV 组，比较两组的临床表现、实验室指标和转归。结果61例儿童传单中有18例（29．51％）为 EBV 合并 MP 感染，其平均年龄为（4．44±2．75）岁，显著大于 EBV 组的（2．90±2．08）岁（t ＝2．401，P ＝0．02）。EBV ＋MP 组中重度扁桃体肿大、肝肿大和并发症（尤其是咳嗽和消化道症状）的比例（分别为88．89％、55．56％和72．22％）显著高于EBV 组（分别为48．84％、13．95％和44．19％）（χ2＝8．529、10．719、3．999，P ＝0．003、0．001、0．046）。EBV ＋MP 组与 EBV 组比较，外周血白细胞[（18．17±7．17）×109／L 比（13．70±7．12）×109／L]、淋巴细胞计数[（11．61±6．04）×109／L 比（7．65±4．82）×109／L]、异型淋巴细胞[（20．69±13．03）％比（13．00±11.20）％]和谷氨酰转肽酶水平[（99．41±91．20）U ／L 比（47．95±69．22）U ／L）]更高（t ＝2．231、2．716、2.215、2．239，P ＝0．029、0．009、0．031、0．029）。两组住院时间及各症状体征恢复时间差异无统计学意义。结论儿童 EBV 合并 MP 感染传单不少见且多见于年长儿，与 EBV 比较，中重度扁桃体肿大、肝肿大、并发症更常见，淋巴细胞及异型淋巴细胞水平更高，但疗效转归无差异。传单儿童应常规检测 MP，对于 EBV 合并MP 感染病例，早诊断早治疗，预后良好。
目的：探討兒童 EB 病毒（EBV）閤併肺炎支原體（MP）感染傳染性單覈細胞增多癥（傳單）的臨床特徵。方法選擇 EBV 檢測暘性的傳單患兒，按照 MP 檢測結果分為 EBV ＋MP 組和 EBV 組，比較兩組的臨床錶現、實驗室指標和轉歸。結果61例兒童傳單中有18例（29．51％）為 EBV 閤併 MP 感染，其平均年齡為（4．44±2．75）歲，顯著大于 EBV 組的（2．90±2．08）歲（t ＝2．401，P ＝0．02）。EBV ＋MP 組中重度扁桃體腫大、肝腫大和併髮癥（尤其是咳嗽和消化道癥狀）的比例（分彆為88．89％、55．56％和72．22％）顯著高于EBV 組（分彆為48．84％、13．95％和44．19％）（χ2＝8．529、10．719、3．999，P ＝0．003、0．001、0．046）。EBV ＋MP 組與 EBV 組比較，外週血白細胞[（18．17±7．17）×109／L 比（13．70±7．12）×109／L]、淋巴細胞計數[（11．61±6．04）×109／L 比（7．65±4．82）×109／L]、異型淋巴細胞[（20．69±13．03）％比（13．00±11.20）％]和穀氨酰轉肽酶水平[（99．41±91．20）U ／L 比（47．95±69．22）U ／L）]更高（t ＝2．231、2．716、2.215、2．239，P ＝0．029、0．009、0．031、0．029）。兩組住院時間及各癥狀體徵恢複時間差異無統計學意義。結論兒童 EBV 閤併 MP 感染傳單不少見且多見于年長兒，與 EBV 比較，中重度扁桃體腫大、肝腫大、併髮癥更常見，淋巴細胞及異型淋巴細胞水平更高，但療效轉歸無差異。傳單兒童應常規檢測 MP，對于 EBV 閤併MP 感染病例，早診斷早治療，預後良好。
목적：탐토인동 EB 병독（EBV）합병폐염지원체（MP）감염전염성단핵세포증다증（전단）적림상특정。방법선택 EBV 검측양성적전단환인，안조 MP 검측결과분위 EBV ＋MP 조화 EBV 조，비교량조적림상표현、실험실지표화전귀。결과61례인동전단중유18례（29．51％）위 EBV 합병 MP 감염，기평균년령위（4．44±2．75）세，현저대우 EBV 조적（2．90±2．08）세（t ＝2．401，P ＝0．02）。EBV ＋MP 조중중도편도체종대、간종대화병발증（우기시해수화소화도증상）적비례（분별위88．89％、55．56％화72．22％）현저고우EBV 조（분별위48．84％、13．95％화44．19％）（χ2＝8．529、10．719、3．999，P ＝0．003、0．001、0．046）。EBV ＋MP 조여 EBV 조비교，외주혈백세포[（18．17±7．17）×109／L 비（13．70±7．12）×109／L]、림파세포계수[（11．61±6．04）×109／L 비（7．65±4．82）×109／L]、이형림파세포[（20．69±13．03）％비（13．00±11.20）％]화곡안선전태매수평[（99．41±91．20）U ／L 비（47．95±69．22）U ／L）]경고（t ＝2．231、2．716、2.215、2．239，P ＝0．029、0．009、0．031、0．029）。량조주원시간급각증상체정회복시간차이무통계학의의。결론인동 EBV 합병 MP 감염전단불소견차다견우년장인，여 EBV 비교，중중도편도체종대、간종대、병발증경상견，림파세포급이형림파세포수평경고，단료효전귀무차이。전단인동응상규검측 MP，대우 EBV 합병MP 감염병례，조진단조치료，예후량호。
Objective To explore the clinical characteristics of infectious mononucleosis (IM)with Epstein-Barr virus (EBV)and mycoplasma pneumoniae (MP)infection in children.Methods Children with IMwho were all positive for EBV and hospitalized in our department from January 2008 to July 2015 were included and divided into the EBV +MP group and the EBV group according to the results of MP.The manifestations,laboratory variables and outcomes were compared in the two groups.Results Of all these 61 cases,18 children (29.51%)were accompanied with EBV and MP infection.The age of the EBV +MP group was older than the EBV group [(4.44 ±2.75)vs (2.90 ± 2.08)years,t =2.401,P =0.02].Moderate to severe enlarged tonsils,hepatomegaly and complications (especially cough and gastrointestinal symptoms)were more common in the EBV +MP group than the EBV group with significant differences (remarkable tonsillitis:88.89 vs 48.84%,hepatomegaly:55.56 vs 13.95%,complications:72.22 vs 44.19%;χ2 =8.529,10.719 and 3.999 respectively;P =0.003,0.001 and 0.046 respectively).The WBC and lymphocyte counts,percentage of abnormal lymphocyte and the levels of glutamyltranspeptidase in the EBV +MP group were also significantly higher than the EBV group [WBC counts:(18.17 ±7.17)×109 /L vs (13.70 ±7.12)×109 /L], lymphocyte counts:(11.61 ±6.04)×109 /L vs (7.65 ±4.82)×109 /L,abnormal lymphocyte proportion:(20.69 ± 13.03)% vs (13.00 ±11.20)%,serum glutamyltranspeptidase:(99.41 ±91.20)U /L vs (47.95 ±69.22)U /L;t =2.231,2.716,2.215 and 2.239 respectively;P =0.029,0.009,0.031 and 0.029 respectively).But the average hospital stay and the recovery time of manifestations showed no significant differences in the two groups (P >0.05). Conclusion IMchildren with EBV and MP infection have more cases with moderate to severe enlarged tonsils,hepa-tomegaly and complications,moreover present higher lymphocyte and similar outcomes.MP should be tested in all IM children.The early diagnosis and treatment are the keys to improve the prognosis of IM children with EBV and MP infection.
