本文關鍵詞：成人傳染性單核細胞增多癥91例臨床特點分析　出處：《重慶醫(yī)科大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 傳染性單核細胞增多癥 成人 EB病毒 臨床特點

【摘要】：目的:分析我院感染科近4年來收治的臨床診斷的成人傳染性單核細胞增多癥(Infectious Mononucleosis,IM)的癥狀、體征、實驗室檢查的特點,提高對該病的認識。方法:收集重慶醫(yī)科大學附屬第一院感染科在2012年1月~2015年12月期間符合EBV感染診斷標準的91例患者的臨床數(shù)據(jù),并對其進行回顧性分析。分析指標包括患者基本信息、發(fā)病時間、癥狀、體征、血液檢查中淋巴細胞比例及異型淋巴細胞比例、肝功,影像學檢查中胸部攝片、腹部B超等。結果:本組患者共有91例,16~25歲有53例(58.2%),男性47例(51.6%),女性46例(48.4%),夏季(6~8月)發(fā)病35例(38.5%),臨床癥狀以三聯(lián)征最常見,包括發(fā)熱86例(94.5%)、咽峽炎69例(75.8%)、頸部淋巴結腫大76例(83.5%),此外,脾臟腫大55例(60.4%),皮疹17例(29.7%),肝臟腫大者5例(5.5%)。實驗室檢查:白細胞計數(shù)(white blood cell count,WBC)10*109/L的患者有59例(64.8%),淋巴細胞百分比35%的患者有83例(91.2%)例,50%者有64例(70.2%),異型淋巴細胞百分比10%的患者數(shù)目為76,占83.5%,轉(zhuǎn)氨酶異常的病例數(shù)為83,占91.2%,高達96.7%的病人乳酸脫氫酶(lactate dehydrogenase,LDH)升高,EB病毒衣殼抗原IgM抗體(Epstein-Barr virus Virus Capsid Antigen IgM,EBV-VCA-IgM)的陽性率為71.4%。治療上予以抗病毒及對癥支持,大多預后良好,僅有一例重癥病例,發(fā)展為及吉雷-巴特綜合征(Guillain-Barre Syndrome,GBS)。結論:成人IM患者的癥狀和陽性體征及實驗室檢查結果較為多樣,臨床醫(yī)生應加深對IM臨床特點的認識,以降低誤診率和漏診率,防治并發(fā)癥。
[Abstract]:Objective: to analyze the clinical symptoms and signs of infectious mononucleosis (IMM) diagnosed in our hospital in recent 4 years. The characteristics of laboratory tests. Methods: the clinical data of 91 patients who met the diagnostic criteria of EBV infection from January 2012 to December 2015 were collected from the infection Department of the first affiliated Hospital of Chongqing Medical University. The indexes included basic information, onset time, symptoms, signs, lymphocyte proportion and abnormal lymphocyte proportion in blood examination, liver function, chest radiography in imaging examination. Results: in this group, there were 91 patients with 16 or 25 years of age, 53 with 58.2% of them, 47 males with 51.6m and 46 females with 48.4%). From summer to August, 35 cases (38.5%) were diagnosed. The most common clinical symptoms were triple sign, including 86 cases of fever (94. 5%) and 69 cases of pharyngitis (75. 8%). The cervical lymph nodes were enlarged in 76 cases (83.5%), splenomegaly in 55 cases (60.4%), rash in 17 cases (29. 7%). Laboratory examination: White blood cell count. There were 59 patients with WBC)10*109/L (64.8%), and 83 patients with lymphocyte percentage of 35% (91.2%) with 50% patients (64 cases with 70.2%). The percentage of abnormal lymphocytes was 10%, the number of patients was 76 (83.5%), and the number of abnormal transaminase was 83 cases (91.2% cases). Lactate dehydrogenase (LDH) was increased in up to 96.7% patients. Epstein-Barr virus Virus Capsid Antigen IgM. The positive rate of EBV-VCA-IgM was 71.4. The patients were treated with anti-virus and symptomatic support. Most of them had a good prognosis, and only one severe case. It developed into Guillain-Barre Syndrome with Guillain-Barre syndrome. Conclusion: the symptoms and positive signs of adult IM patients and the results of laboratory examination are various. The clinicians should deepen their understanding of the clinical characteristics of IM in order to reduce the misdiagnosis rate and missed diagnosis rate and prevent and cure complications.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R512.7

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