【摘要】 目的对传染性单核细胞增多症(IM)患儿的临床特点进行分析总结,降低漏诊、误诊的发生率,提高IM的确诊率。方法回顾性分析87例IM患儿的临床表现及实验室检查结果 ,对误诊病例进行分析。结果 87例IM患儿均有发热症状,体温>38℃患儿占93.10%,咽峡炎患儿占90.80%,淋巴结肿大患儿占77.01%,肝肿大患儿占55.17%,脾肿大患儿占52.87%;白细胞计数与淋巴细胞比例随患儿年龄的减小而异常升高,异型淋巴细胞与丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)含量随患儿年龄递增而异常升高,差异具有统计学意义(P<0.05)。临床IM误诊率为49.43%。结论 IM临床特点多变复杂,误诊率高,必要时结合实验室检查对患儿进行检查,针对检验结果与临床症状综合分析,提高IM临床诊断率,减少误诊。更多还原

【Abstract】 Objective To analyze and summarize clinical characteristics in children with infectious mononucleosis(IM), in order to reduce incidence of missed diagnosis and misdiagnosis, and to improve diagnosis rate of IM. Methods A retrospective analysis was made on clinical manifestations and laboratory examination outcomes in 87 children with IM, and misdiagnosed cases were taken into analysis. Results All the 87 IM children showed fever symptom. Cases with body temperature > 38 ℃ accounted for 93.10%, cases with angina accounted for 90.80%, cases with lymphadenectasis accounted for 77.01%, cases with hepatomegaly accounted for 55.17% and cases with splenomegaly accounted for 52.87%. Lower patient age led to abnormally higher white blood cell count to lymphocyte ratio, and contents of atypical lymphocyte, alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Their difference had statistical significance(P<0.05). Clinical misdiagnosis rate of IM was 49.43%. Conclusion Due to complex clinical characteristics and high misdiagnosis rate in IM, it is essential to provide detection combing with laboratory examination, and comprehensively analyze detection outcomes and clinical symptoms, in order to improve clinical diagnosis rate of IM and decrease misdiagnosis.更多还原