【摘要】 为了解儿童EB病毒(EBV)感染的疾病谱及其临床特征,本文对中山市博爱医院儿科260例经聚合酶链反应(PCR)诊断的EBV感染患儿进行回顾性分析。结果表明,EBV感染患儿在临床上具有以下特征:≤3岁病例增多,共156例,占60.0%;EBV感染后所致疾病多样,累及多系统,咽峡炎和发热是主要临床表现,各占95.4%和86.5%;外周血异型淋巴细胞≥10%有115例,占44.2%。在疾病分布上,EBV感染后患儿以表现为典型传染性单核细胞增多症(IM)为主,共217例,占83.5%;非典型EBV感染(非IM)43例,占16.5%。非IM以呼吸道感染为主,有32例,占74.4%;此外,还有噬血细胞综合征4例、自身免疫性溶血性贫血2例,以及急性淋巴细胞性白血病合并脾性淋巴瘤、系统性红斑狼疮、勒雪病、手足口病及病毒性皮疹各1例。IM中重症病例7例,占3.2%,非IM中重症病例8例,占18.6%(P<0.05)。儿童感染EBV后总体预后良好,慢性活动性EBV感染少见,仅1例。治愈254例,治愈率97.7%;好转2例;放弃2例;重症病例死亡1例。重症病例尤其是噬血细胞综合征患儿预后不良,故应加强对儿童EBV感染防治工作的重视。更多还原

【Abstract】 In order to study the disease spectrum and clinical features of Epstein-Barr virus(EBV) infection in children,260 children with EBV infection diagnosed by serum EBV DNA detection in our hospital were reviewed.The results showed that 60.0%(156/260) were under age of 3;angina and fever were the main clinical manifestations of EBV infection,associated with 95.4% and 86.5% of the studied cases respectively.There were 115 cases(44.2%) with ≥10% peripheral blood atypical lymphocytes.Infectious mononucleosis(IM) was the typical disease associated with 83.5%(217/260) of the studied cases.Among 43 untypical EBV infections,32 were upper respiratory tract infection,4 were hemophagocytic syndrome,2 were autoimmune hemolytic anemia,and one of each for acute lymphoblastic leukemia accompanied by splenic lymphoma,systemic lupus erythematosus,Letterer-Siwe disease,hand foot and mouth disease and viral rash.3.2%(7/217) of IM were severe cases,18.6%(8/43) of untypical EBV infection were severe,and the difference was significant(P<0.05).The prognosis of children with EBV infection was favorable in general.254 cases were cured,with the cure rate of 97.7%.One patient developed persistent chronic active infection,2 improved their conditions,2 were transferred to other facilities,and 1 died.Severe cases had poor prognosis,especially in those with hemophagocytic syndrome.Therefore,more medical attention should be paid to EBV infection in children.更多还原