【摘要】 目的　分析儿童传染性单核细胞增多症 (简称传单 )的临床特点。方法　回顾性分析四川大学华西第二医院儿科 2 0 0 0年 1月至 2 0 0 2年 9月诊治的儿童传单 332例临床资料。结果　传单临床表现多样 ,除发热、咽峡炎、颈淋巴结肿大常见外 ,肝肿大 (76 4 % )、双眼睑水肿 (2 0 5 5 % )、皮疹 (13 80 % ) ;传单肝功变化以酶学改变为主 ,其中以乳酸脱氨酶升高最常见 ;各年龄组传单患儿外周血变异淋巴细胞 (简称异淋 )均明显高于骨髓异淋 (P<0 0 0 1) ,年龄组间差异无显著性 ;早期检测EBV IgM总体阳性率为 5 3 5 7% ,各年龄组间差异无显著性 ;6例重症传单 (死亡 3例 )共同特点为起病急、进展快、临床有严重肝功能及多器官损害 ,其中 2例并发噬血细胞综合征。结论　传单是全身性疾病 ,临床表现多样 ,绝大多数患儿预后良好 ,但重症可致死 ;对于起病急、进展快、肝功损害重、多系统损害者 ,应注意EBV相关性噬血细胞综合征的可能。更多还原

【Abstract】 Objective To analyze the clinical feature of children with infectious mononucleosis(IM).Methods The data of 332 cases of children with IM admitted from January 1,2000 to September 30,2002 were analyzed retrospectively.Results The clinical manifestations of IM were diverse:in addition to the most common manifestations of fever,sore throat and cervical lymphadenopathy,hepatosplenomegaly(76.4%),eyelids edema (20.55%),rash(13.80%) were not unusual.The liver injury of IM was mild,mainly elevated transaminase,especially lactic dehydrogenase(LDH).The number of atypical lymphocyte (AL) in peripheral blood were statistically higher than that in bone marrow(P<0.01) in all age groups.The total positive rate of anti-Epstein-Barr virus VCA-IgM was 53.57% in early stage,no difference was found in all age groups.Six cases of fetal IM (3 died) had acute onset,with progressively deteriorating liver function and multi-organ impairment.Two of 6 cases were complicated with virus associated hemophagocytosis.Conclusion IM is a systematic disease with varied clinical feature;most cases have a good prognosis,but in severe cases it is fetal.For those with acute onset,progressively deteriorated liver function and multi-organ impairment,there is a possibility of complicating fatal IM and EB virus associated hemophagocytosis.更多还原