本文選題：EB病毒 + 感染��； 參考：《新疆醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：觀察分析非典型EB病毒感染的患兒流行病學(xué)特點、疾病譜及血常規(guī)、肝功、心肌酶譜、細胞免疫變化，并探討它們在兒童非典型EB病毒感染診療中的臨床意義，以望提高早期診斷水平及針對性治療,改善預(yù)后。方法：選取2011年3月到2012年9月于新疆醫(yī)科大學(xué)住院治療的136例非典型EB病毒感染的兒童作為觀察組，回顧性分析其流行性特點、臨床表現(xiàn)、輔助檢查、治療及轉(zhuǎn)歸等，并選取在門診作健康體檢的148例健康兒童作為對照組，統(tǒng)計各項臨床資料進行對比分析。結(jié)果：EBV感染全年均可發(fā)病，冬春季節(jié)最常見;男性較女性多見;發(fā)病患兒年齡在～3歲57例,～7歲39例。主要臨床癥狀為：咳嗽、發(fā)熱、咽峽部疼痛最多見；體征：肺部羅音、咽部皰疹、肝脾腫大及水腫等。輔助檢查結(jié)果：血常規(guī)外周血象白細胞總數(shù)最低0.8×10~9/L,最高47×10~9/L,平均值為(23.0±10.4)×10~9/L。WBC分類:85%以上以淋巴細胞為主(淋巴細胞百分比60%)。觀察組患兒谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶、羥丁酸、乳酸脫氫酶、肌酸激酶同工酶的平均值高于對照組，兩組差異有統(tǒng)計學(xué)意義（P0.05）；非典型EBV感染組CD4+水平高于對照組，差異有統(tǒng)計學(xué)意義（P0.05）。最后確診為：急性上呼吸道感染、支氣管炎及肺炎、急性喉炎、淋巴結(jié)炎、心肌損害、過敏性紫癜、腎病綜合征。預(yù)后及轉(zhuǎn)歸：經(jīng)抗病毒及對癥支持治療后均預(yù)后良好。結(jié)論：兒童非典型EBV感染，以嬰幼兒及學(xué)齡前患兒為主，男性多見，一年四季均可發(fā)生，冬春季節(jié)最常發(fā)生。非典型EB病毒感染可致呼吸、循環(huán)、免疫等多系統(tǒng)多器官損害，臨床表現(xiàn)多種多樣,可累及整個機體各個系統(tǒng)，呼吸系統(tǒng)最為常見。EBV感染后可引起肝功、心肌酶的改變；部分患兒EBV感染后存在細胞免疫的紊亂，臨床上EBV感染的治療除抗感染外，還應(yīng)糾正機體免疫功能的紊亂，促進機體免疫功能恢復(fù)。
[Abstract]:Objective: to observe and analyze the epidemiological characteristics, disease spectrum and blood routine, liver function, myocardial enzyme spectrum and cellular immunity of children with atypical Epstein-Barr virus infection, and to explore their clinical significance in the diagnosis and treatment of atypical Epstein-Barr virus infection in children. In order to improve the level of early diagnosis and targeted treatment, improve the prognosis. Methods: 136 children with Epstein-Barr virus (EBV) infection who were hospitalized in Xinjiang Medical University from March 2011 to September 2012 were selected as observation group. The epidemic characteristics, clinical manifestations, adjuvant examination, treatment and outcome were analyzed retrospectively. 148 healthy children were selected as control group. Results the infection of EBV was common in winter and spring, it was more common in male than in female, and the age of infective children was 3 years old, 57 cases were 7 years old, and 39 cases were at the age of 7 years. The main clinical symptoms were cough, fever, pharynx isthmus pain, signs: lung rales, pharyngeal herpes, hepatosplenomegaly and edema. The results of auxiliary examination showed that the total number of leukocytes in peripheral blood was the lowest (0.8 脳 10 ~ (9) / L), and the highest was 47 脳 10 ~ (9) / L, the average value was 23.0 鹵10.4) the percentage of lymphocytes was more than 85% (percentage of lymphocytes was 60%). The mean values of alanine aminotransferase, hydroxybutyric acid, lactate dehydrogenase and creatine kinase isoenzyme in the observation group were higher than those in the control group, the difference between the two groups was statistically significant (P 0.05), the CD4 level in the atypical EBV infection group was higher than that in the control group. The difference was statistically significant (P 0.05). Final diagnosis: acute upper respiratory infection, bronchitis and pneumonia, acute laryngitis, lymphadenitis, myocardial damage, Henoch-Schonlein purpura, nephrotic syndrome. Prognosis and outcome: good prognosis after antiviral and symptomatic support therapy. Conclusion: atypical EBV infection in children is mainly infantile and preschool children, male is more common, it can occur all year round, winter and spring is the most frequent. Atypical Epstein-Barr virus infection can cause respiratory, circulatory, immune and other multi-system multiple organ damage, clinical manifestations are diverse, can affect the entire body system, respiratory system is the most common infection can cause liver function, myocardial enzyme changes; Some children with EBV infection had cellular immune disorder. In addition to anti-infection, the treatment of EBV infection should also correct the disorder of immune function and promote the recovery of immune function.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R725.1

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