本文已被：浏览 792次 下载 700次
投稿时间：2020-12-21 网络发布日期：2021-08-20
投稿时间：2020-12-21 网络发布日期：2021-08-20
中文摘要: 目的 分析近年来儿童传染性单核细胞增多症(IM)的临床特征和流行病学情况。方法 收集2016年1月至2018年12月安徽医科大学第一附属医院儿科住院诊治的IM患儿193例的临床资料,分析其流行病学特点;按照<3岁、3～6岁、>6岁年龄分组,分析各年龄组IM患儿的临床表现。结果 193例患儿中,男100例(51.81%),女93例(48.19%);<3岁68例(35.23%),3～6岁81例(41.97%),>6岁44例(22.80%);2016年至2018年IM发病人数逐年递增,分别为49例(25.39%)、62例(32.12%)、82例(42.49%);全年均有发生,以6～7月、11～12月各有一相对高峰;症状表现有发热 156例(80.83%)，淋巴结肿大160例(82.90%)，咽峡炎124例(64.25%)，脾大92例(47.67%)，眼睑浮肿49例(25.39%)等;并发症以肝损伤［100例(51.81%)］和心肌损伤［59例(30.57%)］为主,此外,中性粒细胞减少43例(22.28%)，腹盆腔积液19例(9.84%)，肺炎6例(3.11%)，血小板减少5例(2.59%)，胆囊泥沙样改变、胆囊壁增厚/水肿5例(2.59%)，心包积液2例(1.04%)。合并感染的病原体有:巨细胞病毒(CMV) 34例(17.62%)、肺炎支原体(MP) 40例(20.73%)、链球菌感染4例(2.07%);以外周血异型淋巴细胞>10%为阳性,外周血异型淋巴细胞阳性患儿115例(59.59%)。结论 IM患儿以3~6岁儿童多见，患儿临床表现复杂多样，肝损害和心肌损害是IM常见并发症，CMV和MP是其常见合并感染的病原体，EB病毒病原学和血清学检测有助于诊断。
中文关键词: 传染性单核细胞增多症 儿童 EB病毒 巨细胞病毒 肺炎支原体
Abstract:Objective To investigate the epidemiological and clinical characteristics of infectious mononucleosis (IM) in children in recent years.Methods The clinical data of 193 IM children hospitalized in the First Affiliated Hospital of Anhui Medical University from January 2016 to December 2018 were collected to analyze their epidemiological characteristics.The patients were divided into <3 years group,3-6 years group and >6 years group.The clinical manifestations in each group were analyzed.Results Of 100 males (51.81%) and 93 females (48.19%)，there were 68 (35.23%) children aged <3 years,81 (41.97%) children aged 3-6 years and 44(22.80%) children aged > 6 years.From 2016 to 2018,the number of IM patients were 49 cases (25.39%),62 cases (32.12%) and 82 cases (42.49%),increasing year by year.IM occurred throughout the year,with relative peaks during June to July and during November to December.There were 156 cases (80.83%) of fever,160 cases (82.90%) of lymphadenopathy,124 cases (64.25%) of pharyngobuccal inflammation,92 cases (47.67%) of splenomegaly and 49 cases (25.39%) of eyelid edema.The main complications were liver injury ［100 cases (51.81%)］ and myocardial injury ［59 cases (30.57%)］.In addition,there were 43 cases (22.28%) of neutropenia,19 cases (9.84%) of abdominal and pelvic effusion,6 cases (3.11%) of pneumonia,5 cases (2.59%) of thrombocytopenia,5 cases (2.59%) of gallbladder silt-like stones or gallbladder wall- thickening edema and 2 cases (1.04%) of pericardial effusion.There were 34 (17.62%) cases co-infected with cytomegalovirus (CMV),40 cases (20.73%) co-infected with mycoplasma pneumoniae (MP) and 4 cases (2.07%) co-infected with streptococcal infection.There were 115(59.59%) children with positive atypical lymphocytes in peripheral blood (>10% as positive).conclusions IM is more common in children aged 3-6 years,with complex and diverse clinical manifestations.Common complications of IM are liver damage and myocardial damage.CMV and MP are the common pathogens in IM children.The etiological and serological detection of Epstein Barr virus is helpful for diagnosis of IM.
文章编号： 中图分类号：R512.7 文献标志码：A
基金项目:国家自然科学基金面上项目(81471617)
附件
| Author Name | Affiliation |
| YUAN Li-ping,WANG Jin-kun,FAN Xiao-chen | Department of Pediatrics,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China |
引用文本：
袁丽萍, 王金坤, 范晓晨.儿童传染性单核细胞增多症的临床特征和流行病学分析[J].中国临床研究,2021,34(8):1031-1034.
袁丽萍, 王金坤, 范晓晨.儿童传染性单核细胞增多症的临床特征和流行病学分析[J].中国临床研究,2021,34(8):1031-1034.