传染性单核细胞增多综合征的诊断与治疗

目的探讨传染性单核细胞增多综合征(传单)的诊断与治疗。方法对39例具有传单临床表现患儿的病原学检查结果、临床特征和血异形淋巴细胞(异淋)变化规律进行回顾性总结。结果39例中EBV引起的传单14例,MP感染引起的12例,可能与MP感染有关2例,EBV和MP混合感染3例,CMV感染1例,病原不明7例。MP感染多为低中度发热,EBV感染以高热为主,EBV和MP混合感染发热持续时间长,与其他组比较差异显著(P<0.05)。MP感染异淋消失所需时间短,与EBV感染者比较差异显著(P<0.05)。结论MP引起的传单与EBV引起的传单十分类似,容易混淆,临床特征对鉴别诊断虽有参考价值,确诊必须靠病原学检查。MP感染需用大环内酯类抗生素治疗,EBV或CMV感染则用更昔洛韦。

Diagnosis and treatment of infectious mononucleosis-like syndrome

Objective To investigate the diagnosis and therapy of the infectious mononucleosis-like syndrome.Methods The etiology,clinical features and changes of atypical lymphocyte of 39 cases with infectious mononucleosis-like syndrome,were analyzed retrospectively.Results Fourteen cases of 39 were infectious mononucleosis caused by EBV,12 were caused by mycoplasma pneumoniae(MP) infection,2 cases perhaps were related to MP,3 induced by EBV and MP,1 caused by cytomegalovirus(CMV),7 were unknown.The patients with infectious mononucleosis-like syndrome induced by MP mostly had low-or middle-grade fever,induced by EBV mainly high fever,and the time of fever was longest in the mixed infection due to EBV and MP.The extinction time of abnormal lymphocyte caused by MP was shorter than that of else other pathogen(P<0.05).Conclusion The infectious mononucleosis-like syndrome caused by EBV is quite similar to that induced by MP.Although there are differences in fever degree and the changes of abnormal lymphocyte,it is difficult for us to distinguish them.The etiologic diagnosis is absolutely necessary for treatment.The macrolides antibiotics such as erythromycin produce very effective results for MP infection,but Ganciclovir is useful for virus.