儿童传染性单核细胞增多症实验室分析

目的探讨传染性单核细胞增多症的实验室检查对临床治疗的指导意义。方法回顾性分析46例儿童传染性单核细胞增多症者血常规、生化、免疫和细菌学检测,并进行统计学分析。结果外周血异型淋巴细胞比率大于10%有25例(54.3%),白细胞计数超过10.0×109/L有20例(43.5%),淋巴细胞比率超过50%有32例(69.6%),红细胞沉降率大于25mm/h有22例(47.8%),异型淋巴细胞比率与发病年龄呈负相关;天门冬氨酸氨基转移酶异常有24例(52.2%),丙氨酸氨基转移酶异常有21例(45.7%),胆汁酸异常有20例(43.5%)、γ-谷胺酰转移酶异常有18例(39.1%),患儿组4项肝功能检测指标水平高于健康对照组,差异有统计学意义;血清免疫球蛋白IgG异常有17例(37.0%)、IgA异常有2例(4.3%)、IgM异常有21例(45.7%)、补体C3异常有18例(39.1%)、总补体活性50异常有10例(21.7%),患儿组IgG和补体C3水平明显高于对照组,差异有统计学意义;肺炎支原体抗体阳性有25例(45.7%),咽拭子培养细菌感染有6例(13.0%)。结论儿童传染性单核细胞增多症易发生免疫功能紊乱,出现肝脏功能受损,早期联合治疗应受到重视。

Analysis of laboratory examination in children with infectious mononucleosis

Objective To disclose the significance of laboratory check-up of children with infectious mononucleosis（IM） in clinic treatment.Methods Retrospective analysis was performed on routine blood test,biochemical and immunologic detection from 46 patients diagnosed as infectious mononucleosis,the datum were analyzed by statistic software.Results There were 25 samples（54.3%） in the ratio of atypical lymphocyte 10%,20 samples（43.5%） in WBC count 10.0×109/L,32 samples（69.6%）in the ratio of Lymphocyte 50%,22 samples（47.8%）in ESR25 mm/h.There was positive correlation to the decrease of the ratio of atypical lymphocyte with age.AST levels of 24 samples（52.2%） were abnormal,ALT of 21 samples（45.7%） were abnormal,TBA levels of 20 samples（43.5%） were abnormal,GGT levels of 18 samples（39.1%） were abnormal.The level of liver lesions had difference between children with IM and normal children.IgG levels of 17 samples（37.0%） were abnormal,IgA levels of 2 samples（4.3%） were abnormal,IgM levels of 21 samples（45.7%） were abnormal,C3 of 18 samples（39.1%）and CH50 of 10 samples（21.7%）were abnormal.The levels of IgG and C3 had difference between Children with IM and normal children.Mycoplasma pneumoniae antibody of 25 samples（45.7%） were positive.Pharyngeal swab cultivate of 6 samples（13.0%）were bacterial infection.Conclusion Immunologic abnormity can usually occur in children with IM whose liver function had been damaged,so early united treatment should be emphasized in children with IM.