【摘要】 目的 分析传染性单核细胞增多症（IM）患儿合并肝功能损伤的临床特征和预后。方法 选取2020年1月至2022年12月阜阳市人民医院收治的148例IM患儿作为研究对象，根据患儿病程中是否发生肝功能损伤，分为肝功能损伤组和肝功能正常组。收集并比较两组患儿一般临床特征和实验室检查指标，以及90 d随访的预后情况。结果 148例IM患儿中发生肝功能损伤71例，发生率为48.0%。在一般临床特征和实验室检查指标中，肝功能损伤组患儿年龄、淋巴细胞百分比和表现出肝肿大、脾大、眼睑浮肿和皮疹的患者比例高于肝功能正常组，而中性粒细胞百分比、中性粒细胞/淋巴细胞比值（NLR）、CD8~+细胞和CD4~+/CD8~+细胞比值低于肝功能正常组（P<0.05）；随访结果表明，肝功能损伤组患儿发热持续时间、住院时间、淋巴结肿大持续时间、淋巴细胞比例恢复正常所需时间及血清EBV DNA转阴时间较肝功能正常组延长，且并发症的发生率高于肝功能正常组（P<0.05）。结论 相较于肝功能正常的IM患儿，肝功能损伤患儿病情更为严重，预后恢复相对较慢，且并发症发生风险更高，其主要原因可能与该类患儿免疫应答反应强烈有关。更多还原

【Abstract】 Objective To analyze the clinical features and prognosis of children with infectious mononucleosis(IM) complicated with hepatic impairment. Methods A total of 148 children with IM admitted to our hospital from January 2020 to December 2022 were enrolled, and assigned to hepatic impairment group or normal liver function group based on the occurrence of hepatic impairment during the course of the disease. The data of clinical evaluation and laboratory tests were collected and compared between groups. The children were followed up for 90 days to compare the prognosis of children between the two groups. Results Hepatic impairment occurred in 71 of 148 children with IM, with an incidence rate of 48.0%. The children complicated with hepatic impairment were associated with older age, significantly higher lymphocyte percentage, and higher prevalence of hepatomegaly,splenomegaly, eyelid swelling, and rashes, but significantly lower neutrophil percentage, neutrophil-to-lymphocyte ratio(NLR),CD8+ cell, and CD4+/CD8+ cell ratio compared to the children with normal liver function(P < 0.05). Followup data showed that the children complicated with hepatic impairment had longer duration of fever, hospital stay, duration of lymph node enlargement, and longer time for lymphocyte percentage to recover to normal and longer time to serum EBV DNA conversion compared the children with normal liver function. The children complicated with hepatic impairment showed higher incidence of complications than the children with normal liver function(P < 0.05). Conclusions Hepatic impairment may predict a more severe condition, longer time to recover, and a higher risk of complications in the children with IM, which may be due to strong immune response.更多还原