传染性单核细胞增多症患儿合并肝损害的临床特点及相关因素探讨

目的：探讨传染性单核细胞增多症（IM）患儿合并肝损害的临床特点及相关因素。方法：回顾分析2011年1月～2016年5月我院收治的144例IM患儿的临床资料。血清丙氨酸氨基转移酶（ALT）测定采用速度法，血清C反应蛋白（CRP）测定采用免疫比浊法，白细胞计数（WBC）测定采用电阻抗法，肝脏肿大采用肝脏B超判断，CD4+细胞计数、CD8+细胞计数、CD4+细胞/CD8+细胞比值测定采用流式细胞仪法。结果：①144例IM患儿，其中75例患儿血清ALT大于其参考区间上限（45U/L），占比52.08%。②血清ALT异常的75例IM患儿，45U/L＜血清ALT＜90U/L共31例（41.33%），90U/L≤血清ALT＜200U/L共29例（38.67%），血清ALT≥200U/L共15例（20.00%）。144例IM患儿肝损害发生率为30.56%（44/144）。③肝损害患儿组与非肝损害患儿组性别、血清CRP相比差异无显著性，肝损害患儿组年龄、WBC、肝脏肿大阳性率、CD8+细胞计数显著高于非肝损害患儿组，CD4+细胞计数、CD4+细胞/CD8+细胞比值显著低于非肝损害患儿组，差异有显著性。结论：IM患儿肝损害与患儿年龄、WBC、肝脏肿大、CD8+细胞计数、CD4+细胞计数、CD4+细胞/CD8+细胞比值等指标相关。

Children with infectious mononucleosis to explore the clinical characteristics of liver damage and related factors

Objective to discuss the children with infectious mononucleosis(IM)the clinical characteristics of liver dam-age and related factors. Methods retrospective analysis in January 2011-in May 2016 in our hospital clinical data of 144 cases of children with IM. Determination of serum alanine aminotransferase(ALT)USES the velocity method, determination of serum c-reactive protein(CRP)by immune turbidimetry, white blood cell count(WBC)determination of the resistance KangFa, hepatomegaly with hepatic B to exceed, CD4+cell count, CD8+cell count, determination of the ratio of CD4+/CD8+cells by flow cytometry instrument method. Results (1), 144 cases of children with IM, of which 144 cases of children with serum ALT is greater than the reference range(45 u/L), accounted for 52.08%. (2)for children with 75 cases of abnormal serum ALT IM 45 u/L serum ALT<<90 u/L, a total of 31 cases(41.33%), 90 u/L or less serum ALT<200 u/L, a total of 29 cases(38.67%), serum ALT 200 u/L or a total of 15 cases(20.00%). The incidence of 144 cases of children with IM liver damage was 30.56%(44/144). Liver damage(3)the group with the children with liver damage in children with gender, there was no significant difference com-pared with serum CRP, liver damage in children with group of age, the WBC, hepatomegaly, positive, CD8+cell count liver damage is significantly higher than the children group, CD4+cell count and CD4+/CD8+cells ratio was significantly lower than the children with liver damage group, with significant difference . Conclusion IM with liver damage and age, the WBC, hepatomegaly, CD8+cell count and CD4+cell count and CD4+/CD8+cells ratio and other related indicators.