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目的探讨传染型单核细胞增多症(传单)、类传单和EB病毒(EBV)感染病例的临床特点。方法对重庆医科大学附属儿童医院2003—2004年收治的602例传单、类传单和EBV感染患儿的相关资料进行回顾性分析。结果传单组的临床表现较EBV感染组典型,淋巴结肿大和眼睑水肿的发生率显著高于类传单组,传单组眼睑水肿的发生率(62.7%)已接近常见的典型表现出现的比率;类传单组病例微小病毒(HPVB19)的感染率为54.8%,显著高于传单组;3组病例肝功能改变都以酶学改变为主,其中LDH改变最为明显;血液系统并发症表现为贫血、粒细胞减少和血小板减少,各组发生率没有统计学差异;类传单组病例肺炎发生率显著高于传单组;EBV感染组出现传单组没有的ITP病例和脑炎病例。结论眼睑水肿对传单有着与其它典型表现同样重要的诊断意义;HPVB19是类传单的一个重要病原;EBV感染后部分病例发展为传单,部分病例仍以EBV感染状态存在,可能存在异常的免疫反应。

Infectious mononucleosis and related diseases

Objective Infectious mononucleosis is becoming more common in pediatric clinic.The study analyzed the manifestation of EBV related diseases to provide references for the clinical management.Methods All 602 cases were grouped with IM (n=279),IM-like disease (n=80 ) and EBV infection (n=243),and were evaluated retrospectively.SPSS11.5 software was used for statistical analysis.Results The percent of typical clinical findings in IM group was significantly higher than those in EBV infection group,but only the percent of enlarged lymph nodes and eyelid edema was higher than those in IM-like group.The percent of HPVB19 in IM-like group (54.8%) was significantly higher than that in IM group.The liver function with abnormal hepatic enzymes was the most common results in the three groups and LDH abnormality was the most significant.The percent of anemia,granulopenia and thrombocytopenia in the three groups showed no significant differences.The percent of pneumonia in IM-like group was significantly higher than that in IM group.Conclusion Eyelid edema shows the same important value as the other typical manifection for IM diagnosis.HPVB19 is the most common pathogens in IM-like disease.The mechanism for the patients with EBV infection and IM disease may attribute to the different immune state.