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目的:探讨儿童传染性单核细胞增多症的临床特点。方法:收集本院儿科2003年4月至2008年6月57例儿童传染性单核细胞增多症的临床资料进行回顾性分析。结果:57例患儿中持续发热5 d以上者37例(37/57,64.9%),无发热5例(5/57,8.8%),淋巴结肿大54例(54/57,94.7%);合并支原体感染21例(21/39,53.8%);合并肺炎13例(13/57,22.8%),其中支原体肺炎6例;异形淋巴细胞计数10%以上者43例(43/57,72%),血清谷丙转氨酶升高35例(35/57,63.6%),异型淋巴细胞比例与肝功能存在正相关关系(r=0.562);合并支原体感染的IM病例在发热天数、淋巴结肿大、肝脾肿大、白细胞数、异型淋巴细胞、血清ALT等临床表现上与无合并支原体感染的IM病例差异无显著性,但在住院天数和住院费用上明显高于后者。结论:传染性单核细胞增多症的外周血异型淋巴细胞比例与血清ALT存在正相关关系,虽然合并支原体感染的IM病例在临床表现上无显著性变化,但是临床上仍要加强支原体的检查和治疗。
Objective: To investigate the clinical features of childhood infectious mononucleosis. Methods: The clinical data of 57 cases of infectious mononucleosis in children from April 2003 to June 2008 in our hospital were retrospectively analyzed. Results: Among the 57 cases, 37 cases (37/57, 64.9%) had persistent fever more than 5 days, 5 cases (5/57, 8.8%) had no fever, 54 cases (54/57, 94.7% (21/39, 53.8%) were complicated with mycoplasma infection, 13 cases (13/57, 22.8%) were complicated with pneumonia, of which 6 cases were mycoplasma pneumonia and 43 cases with abnormal lymphocyte count more than 10% (43/57, 72 %). Serum alanine aminotransferase (ALT) was elevated in 35 cases (35/57, 63.6%). There was a positive correlation between the proportion of atypical lymphocytes and liver function (r = 0.562) , Hepatosplenomegaly, white blood cell count, atypical lymphocytes, serum ALT and other clinical manifestations of non-merger mycoplasma infection IM cases no significant difference, but the hospital stay and hospitalization costs were significantly higher than the latter. Conclusion: There is a positive correlation between the proportion of peripheral blood atypical lymphocytes and the serum ALT in infectious mononucleosis. Although the clinical manifestations of patients with mycoplasma infection were not significantly changed, the detection of mycoplasma should be strengthened treatment.