【摘要】 目的探讨儿童EB病毒(EBV)感染病例和传染性单核细胞增多症(IM)的临床表现和实验室检查特点。方法收集2010年1月至2011年5月广州医学院第一附属医院儿科收治的108例EBV感染患儿临床资料,其中诊断IM者77例,进行回顾性分析。结果本组病例以学龄前期儿童最多(41.6%),幼儿期也不少见(36.4%);眼睑水肿是IM早期较常见的临床表现,发生率高于脾脏肿大和皮疹;异形淋巴细胞≥10%病例仅占33.8%;IM组血浆中EBV-DNA拷贝数1.04×103～2.88×105拷贝/mL,均数7.18×104拷贝/mL;本组3例EBV-HLH血清学抗体谱抗VCAIgM均阴性,表现为EBV既往感染(2例)和再激活(1例),EBV-DNA拷贝数均值为2.71×107拷贝/mL。结论眼睑水肿与其他典型表现一样对IM具有诊断价值;异形淋巴细胞在诊断IM特别是婴幼儿IM的应用价值应该进一步探讨;检测外周血EBV-DNA拷贝数能更好反应体内EBV的活动情况;定量检测外周血EBV-DNA拷贝数在判断EBV感染的病情转归方面比血清学抗体检测更具价值。更多还原

【Abstract】 Objective To investigate clinical characteristics and laboratory feature of Epstein-Barr Virus ( EBV ) infection and infectous mononucleosis in children. Method A retrospective study was conducted in 108 hospitalized patients who were enrolled from Jan 2010 to May 2011.Among them 77 patients were diagnosed with IM. Results In our investigation most of the IM was seen in preschool children ( 41.6% ) and in young children ( 36.4% ) . Eyelid edema was common clinical manifestations of IM , the percentage of which was higher than enlarged spleen and rash in IM group.Increased ratio of atypical lymphocytes (≥ 10% ) was seen in only 33.8% of the IM patients.The EBV-DNA level in plasm of IM patients was in the range of 1.04 × 10 3 ～ 2.88 × 10 5 copies/mL , with a mean value of 7.18 × 10 4 copies/mL. All of 3 cases of EBV-HLH in our study were negative in sera of anti-VCA-IgM , but were positive of EBV-DNA in plasma and mean EBV-DNA loads were 2.71 × 10 7 copies/mL. Conclusion In our observation eyelid edema has the same diagnostic value as the other typical manifections in IM.The clinical significance of atypical lymphocyte in the diagnosis of IM , especially in infants and young children , needs to be further confirmed.EBV-DNA copy in peripheral blood seems to be closely related to the active infection of EBV and in EBV-HLH the diagnostic value of detection of EBV-DNA in serum by FQ-PCR should be emphasized.更多还原