EB病毒相关传染性单核细胞增多症81例临床分析

Clinical Analysis of 81 Cases of Infectious Mononucleosis in Children

摘要: 目的：分析儿童传染性单核细胞增多症临床特点，提高对传染性单核细胞增多症的认识。方法：回顾性分析2018年1月至2020年9月就诊于我院传染性单核细胞增多症患儿81例的临床资料，并总结分析其临床特点。结果：77例患儿治愈出院，3例患儿好转出院，1例转院，其中男女比例：2.52:1 (58男，23女)，发病高峰年龄集中在1~6岁，临床表现中以发热、颈部淋巴结肿大、咽峡炎等临床表现多见，其中发热69例，占85.18%；颈部淋巴结肿大70例，占86.41%；咽峡炎63例，占77.77%，临床表现变化多样，入院时易误诊，其中误诊为化脓性扁桃体炎、颈部淋巴结炎、川崎病、肾小球肾炎等多见，入院时误诊率为30.43%。病程中合并肺炎26例，占比32.09%；肝损害21例，占比25.92%；心肌损害44例，占比54.32%；中性粒细胞减少12例，占比14.81%；合并蛋白尿9例，占11.11%；合并贫血1例，占1.23%；其中1例诊断并发EB病毒相关嗜血综合征，占1.23%。结论：儿童传染性单核细胞增多症临床表现多样，多发于男性，且以1~6岁常见，肺炎、肝损害以及心肌损害为主要合并症，易误诊，多数预后好。

Abstract: Objective: To analyze clinical characteristics of infectious mononucleosis in children, improve the knowledge of infectious mononucleosis. Methods: The clinical data of 81 children with infectious mononucleosis in our hospital from January 2018 to September 2020 were retrospectively analyzed, and their clinical characteristics were summarized. Results: 77 cases cured and discharged, 3 cases improved and discharged, 1 case of courtyard, percentage of men and women: 2.52:1 (58 male, female), peak onset age concentrated in 1 to 6 years of age, clinical manifestation was in fever, cervical lymph node enlargement, clinical manifestations, such as angina; 69 patients with fever (85.18%); Neck lymph nodes 70 cases, accounted for 86.41%; Angina 63 cases (77.77%); the clinical manifestations were of variety, easy misdiagnosis on admission, including the misdiagnosis for suppurative tonsillitis, neck lymph node phlogistic, kawasaki disease, glomerulonephritis, etc., the misdiagnosis rate was 30.43%, in the course of merging pneumonia 26 cases, accounted for 32.09%; liver damage 21 cases, accounted for 25.92%; Myocardial damage in 44 cases, accounted for 54.32%; Neutropenia in 12 cases, accounted for 14.81%; Merger of proteinuria, 9 cases (11.11%); Merger of anemia in 1 case (1.23%); among them, 1 case was diagnosed concurrent epstein-barr virus associated blood syndrome, accounting for 1.23%. Conclusion: The clinical manifestations of infectious mononucleosis in children are various, most of them are male, and in 1~6 years old. Pneumonia, liver damage and myocardial damage are the main complications, which are easy to be misdiagnosed and most of them have good prognosis.