传染性单核细胞增多症患儿早期危险因素的识别

目的检测EB病毒感染的传染性单核细胞增多症（infectious mononucleosis，IM）患儿外周血淋巴细胞亚群、免疫球蛋白定量、乳酸脱氢酶（LDH）及乳酸（LAC）的表达变化并分析其临床意义。方法选取90例感染EB病毒致IM患儿作为回顾研究对象，IM患儿常规抗病毒支持治疗不能控制或合并较重并发症44例作为观察组，IM患儿常规抗病毒支持治疗病情顺利缓解46例作为对照组。入院后第1~2天检测患儿外周血淋巴细胞亚群（CD3+、CD4+、CD8+、CD3-CD19+、NK细胞）、免疫球蛋白（IgG、IgA、IgM）、LDH及LAC水平。结果与对照组比较，观察组患儿外周血CD3+、CD8+、LDH表达升高，CD4+、NK细胞表达降低（P<0.05~P<0.01）；2组CD3-CD19+、LAC、IgG、IgA和IgM表达差异均无统计学意义（P>0.05）。结论关注IM患儿外周血淋巴细胞亚群，尤其是CD3+、CD4+、CD8+、NK细胞以及LDH的表达，有助于早期识别IM患儿病情的严重程度，指导积极合理治疗，避免错过最佳治疗时机。

Identification of early risk factors in children with infectious mononucleosis

ObjectiveTo detect the expression changes of peripheral blood lymphocyte subsets, immunoglobulin quantity, lactate dehydrogenase(LDH) and lactate(LAC) in children with infectious mononucleosis(IM) infected by EB virus, and analyze their clinical significance.MethodsNinety children with IM caused by EB virus were investigated.Forty-four children with IM, who could not be controlled by routine antiviral support therapy or had severe complications, were set as the observation group, and 46 patients with IM, who were successfully relieved by routine antiviral support therapy, were set as the control group.The lymphocyte subsets(CD3+, CD4+, CD8+, CD3- CD19+ and NK cells), immunoglobulin(IgG, IgA and IgM), LDH and LAC in peripheral blood in two groups were detected after 1-2 days of admission.ResultsCompared with the control group, the expression of CD3+, CD8+ and LDH in the peripheral blood increased, while the expression of CD4+ and NK cells decreased in the observation group(P<0.05 to P<0.01).The differences of the expression of the CD3-CD19+, LAC, IgG, IgA and IgM between two groups were not statistically significant(P>0.05).ConclusionsPaying attention to the lymphocyte subsets in the peripheral blood of children with IM, especially the expression of CD3+, CD4+, CD8+, CD3-CD19+, NK cells and LDH, can help to identify the severity of disease in children with IM at an early stage, guide active and reasonable treatment, and avoid missing the best treatment opportunity.