目的 分析人类疱疹病毒(EBV)致传染性单核细胞增多症(IM)患儿病毒量与临床特征的关系。方法 选取我院2016年1月—2021年1月收治的EBV定量阳性的IM患儿128例,按照患儿EBV含量分为低病毒量组(n=64)和高病毒量组(n=64)。比较不同病毒含量组患儿的症状体征、实验室检查及临床特征,并分析具有统计学差异的指标与病毒量之间的相关性。结果 高EBV含量组患儿丙氨酸氨基转移酶、乳酸脱氢酶、血沉、外周血白细胞计数指标水平均高于低EBV含量组(P<0.05)。患儿的退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间均随着EBV含量的增加而延长(P<0.05)。EBV含量与退热时间、淋巴结缩小时间、肝脾肿大消退时间及住院时间成正相关(r=0.453,0.458,0.402,0.415,P<0.05)。结论 EBV含量越高,IM患儿住院时间及临床指标恢复时间越长,因此临床治疗IM患儿时可以根据EBV含量的高低进行病情评估。

Objective To analyze the relationship between viral load and clinical characteristics in children with infectious mononucleosis (IM) caused by Epstein-Barr virus (EBV). Methods A total of 128 children with IM who tested positive for EBV and admitted to our hospital from January 2016 to January 2021 were selected and divided into low virus group (n=64) and high virus group (n=64) according to their EBV level. The symptoms and signs, laboratory examinations and clinical characteristics of two groups were compared, and the correlation between the statistically different indicators and the amount of virus were analyzed. Results In children with high EBV level, the levels of alanine aminotransferase, lactate dehydrogenase, erythrocyte sedimentation rate, and peripheral blood white blood cell count were higher than low EBV level group (P<0.05). The time of fever, lymph node shrinkage, hepatosplenomegaly to subside, and hospitalization time of the children were all prolonged with the increase of EBV level (P<0.05). The level of EBV was positively correlated with the time to allay fever, the time to shrink the lymph nodes, the time to improve hepatosplenomegaly, and the length of hospital stay (r=0.453, 0.458, 0.402, 0.415,P<0.05). Conclusions The higher EBV level, the longer hospitalization time and recovery time of clinical indicators in children with IM. Therefore, the disease assessment of children with IM can be based on EBV level.

目的 分析传染性单核细胞增多症患者临床症状和异型淋巴细胞百分比(ALY%)、肝功能等实验室检查特点,为临床提高对该病的诊断、病情评估和治疗提供参考。方法 2017年1月— 2019 年6月在深圳市中医院儿科住院治疗的73例传染性单核细胞增多症患儿,采取回顾分析法,归纳总结患者的临床症状,根据患者的异型淋巴细胞数量进行分组,A组异型淋巴细胞数量占比为4.5%～10.0%(8例);B组异型淋巴细胞数量占比为10.01%~15.0%(15例); C组异型淋巴细胞数量占比为15.01%～20%(20例); D组异型淋巴细胞数量占比为20.01%～25.0%(13例); E组异型淋巴细胞数量占比超过25.01%～30%(17例)。总结本病的临床特点,分析异型淋巴细胞百分比和肝功能损伤的相关性。结果 1.传染性单核细胞增多症的主要临床表现为发热、咽痛、伪膜和颈部淋巴结肿大。2.随着异型淋巴细胞百分比的增加,AST异常患儿越多,当异型淋巴细胞数量占比超过25.01%,AST明显升高,提示肝功能损伤越严重。结论 传染性单核细胞增多症患者的异型淋巴细胞数量与肝功能损伤存在一定的联系,可以作为患者病症诊断的重要参考,随着异性淋巴细胞百分比增加,患儿肝功能异常出现比率越高,可以指导临床判断预后和治疗。