论文部分内容阅读
目的探讨小儿传染性单核细胞增多症 (IM)的临床特征、诊断与治疗方法。方法回顾分析 12 4例确诊为IM患儿的临床资料和治疗效果。结果IM发病 3岁以下占 5 1.6 % ;发热、咽峡炎、肝脾及淋巴结肿大典型临床表现发生率均在 90 %以上 ,而鼻塞、眼睑水肿、皮疹、尿少等不常见临床表现发生率也较高 (约占 10 %～ 32 % ) ;外周血异形淋巴细胞 >10 % 92例 (72 .6 % ) ,嗜异性凝集试验阳性 2 2 .9% (2 5 / 10 9) ,VCA IgM阳性 76 .7% (2 3/ 30 ) ,EBV DNA阳性 16例(16 / 4 3) ,合并支原体感染 32 .4 % (12 / 37)。干扰素或更昔洛韦治疗组均较利巴韦林和莪术油组的临床症状、体征恢复快 (P <0 .0 5 )。结论IM发病年龄呈提前趋势 ,且合并支原体感染者增多 ,其临床表现既相对集中 ,又呈多样性。VCA IgM和EBV DNA检测可提高对不典型IM的早期诊断。干扰素、更昔洛韦明显提高IM近期疗效。
Objective To investigate the clinical features, diagnosis and treatment of childhood infectious mononucleosis (IM). Methods The clinical data and therapeutic effects of 124 cases diagnosed as IM were retrospectively analyzed. Results The incidence of IM was 5 1.6% under 3 years of age. The incidences of fever, angina, liver, spleen and lymph nodes were more than 90%, while the common clinical manifestations of nasal obstruction, eyelid edema, rash and oliguria were uncommon (10% -32%), peripheral blood lymphocytes> 10%, 92 cases (72.6%), heterophile agglutination test (22.5%), VCA IgM was positive in 76.7% (23/30), EBV DNA was positive in 16 cases (16/43) and mycoplasma was infected in 32.4% (12/37). Interferon or ganciclovir treatment group than ribavirin and Curcuma oil group clinical symptoms, signs recovered quickly (P <0.05). Conclusion The age of onset of IM showed an earlier trend and the number of patients with mycoplasma infection increased. Their clinical manifestations were both relatively concentrated and varied. VCA IgM and EBV DNA testing can improve the early diagnosis of atypical IM. Interferon, ganciclovir significantly improve the immediate effect of IM.