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目的探讨传染型单核细胞增多症(传单)、类传单和EB病毒(EBV)感染病例的临床特点。方法对重庆医科大学附属儿童医院2003—2004年收治的602例传单、类传单和EBV感染患儿的相关资料进行回顾性分析。结果传单组的临床表现较EBV感染组典型,淋巴结肿大和眼睑水肿的发生率显著高于类传单组,传单组眼睑水肿的发生率(62.7%)已接近常见的典型表现出现的比率;类传单组病例微小病毒(HPVB19)的感染率为54.8%,显著高于传单组;3组病例肝功能改变都以酶学改变为主,其中LDH改变最为明显;血液系统并发症表现为贫血、粒细胞减少和血小板减少,各组发生率没有统计学差异;类传单组病例肺炎发生率显著高于传单组;EBV感染组出现传单组没有的ITP病例和脑炎病例。结论眼睑水肿对传单有着与其它典型表现同样重要的诊断意义;HPVB19是类传单的一个重要病原;EBV感染后部分病例发展为传单,部分病例仍以EBV感染状态存在,可能存在异常的免疫反应。
Objective To investigate the clinical features of infectious mononucleosis (leaflets), leaflets and Epstein-Barr virus (EBV) infection. Methods A retrospective analysis of 602 cases of leaflets, class leaflets and EBV-infected children admitted to Children’s Hospital of Chongqing Medical University from 2003 to 2004 was conducted. Results The clinical manifestations of leaflet group were significantly higher than that of EBV infection group. The incidence of lymphadenopathy and eyelid edema was significantly higher than that of leaflet group. The incidence of eyelid edema in leaflet group (62.7%) was close to that of common typical manifestation. The infection rate of the group of cases of parvovirus (HPVB19) was 54.8%, which was significantly higher than that of the case-control group. The changes of liver function in three groups were mainly changed by enzymology, of which the change of LDH was most obvious. The complication of hematological system was anemia, granulocyte Reduce and thrombocytopenia, the incidence of each group has no statistical difference; the incidence of pneumonia in the leaflet group was significantly higher than that in the leaflet group; EBV infection group did not have the ITP cases and the encephalitis cases in the leaflet group. Conclusions Eyelid edema has diagnostic significance on leaflets as important as other typical manifestations. HPVB19 is an important pathogen of leaflet. Some cases developed as leaflets after EBV infection. Some cases still exist EBV infection and may have abnormal immune response.