76例儿童传染性单核细胞增多症及其并发症临床特征分析.DOCVIP

临床医学论文-76例儿童传染性单核细胞增多症及其并发症临床特征分析 【关键词】? 儿童；传染性单核细胞增多症；并发症；特征 　　【摘要】 目的?? 探讨传染性单核细胞增多症及其并发症患儿的临床特征。 方法?? 对76例传染性单核细胞增多症患儿的临床资料进行回顾性分析。 结果?? 76例患儿中42.1%有发热、咽峡炎、肝脾大、淋巴结大、皮疹等典型症状；早期淋巴细胞≥50%者26例（34.2%），单核细胞＋淋巴细胞≥60%者39例（51.3%），异型淋巴细胞≥5%者68例（89.4%）;消化系统主要表现为肝脏酶学改变：乳酸脱氢酶升高57例（75%），天冬氨酸转氨酶升高52例（68.4%），丙氨酸转氨酶升高47例（61.8%），总胆汁酸升高34例（44.7%）；呼吸系统表现为支气管炎和支气管肺炎30例;抽搐3例。对临床表现类似传染性单核细胞增多症，但EBVVCAIgM阴性或嗜异凝集试验阴性的患者需进一步作CMV病毒特异性抗体检测。结论?? 传染性单核细胞增多症是累及多系统的全身性疾病，临床表现多样，主要表现为感染相关性淋巴或淋巴样腺体组织反应性改变和多器官功能所损。大多数传染性单核细胞增多症呈良性临床经过，预后良好。 　　【关键词】 儿童；传染性单核细胞增多症；并发症；特征 　　Clinical features of infectious mononucleosis and its complications in 76 child patients 　　【Abstract】 Objective?? To explore clinical features of infectious mononucleosis(IM) and its complications in 76 child patients. Methods?? Clinical data of 76 children with IM were retrospectively analyzed. Results?? 42.1% of them had typical clinical manifestations such as fever, angina, hepatosplenomagaly, lymphadenhypertrophy, erythra and so on; 26 children (34.2%) exhibited early lymphocytes≥50%, 39(51.3%) did monocytes + lymphocytes≥60% and 68(89.4%) did atypical lymphocytes≥5%; the main manifestation of digestive system was changes of hepatic enzymes:57(75%) showed the elevation of lactic dehydrogenase, 52(68.4) did the elevation of aspartase transaminase,47(61.8%) did the elevation of alanine transaminase and 34(44.7%) did the elevation of total bile acid;30 had bronchitis and bronchopneumonia; 3 showed convulsion. For cases that the clinical manifestations resembled IM but had negative EBVVCAIgM or negative Paul-Bunnell test, specific antibodies of cytomegalovirus should be further detected. Conclusion牋 IM is a systematic disease with varied clinical feature, its main manifestations are reactive changes of lymph or lymphoid glandular tissue and functional impairments of multiple organs. The mass of the IM exhibits benign clinical course and its prognosis is favorable. 　　【Keywords】 Children; IM；complication; feature 　　传染性单核细胞增多症（Infect