兒童傳染性單核細胞增多癥的臨床特征及并發(fā)肝損害的相關因素分析
發(fā)布時間：2018-08-21 10:17
【摘要】：目的分析兒童傳染性單核細胞增多癥(infectious mononucleosis,IM)的臨床特征,以及肝功能損害的相關因素,以期早期發(fā)現和干預IM伴肝功能損害。方法回顧性分析102例IM住院患兒的臨床資料,對IM患兒的人口學特征,臨床表現,實驗室檢查,并發(fā)癥等進行統計學分析。并對56例伴肝功能損害的IM患兒的年齡、性別、發(fā)病季節(jié)、疾病嚴重程度等因素進行統計學分析,得出是否存在相關性。結果1、102例住院患兒,男女比例為2.29:1,男多于女。年齡分布在8個月~12歲10個月,平均年齡為(4.75±2.82)歲。3~7歲組人數最多。IM發(fā)病高峰為秋季。2、IM患者臨床癥狀中,發(fā)熱、頸部淋巴結腫大和咽峽炎為IM典型的三聯征。咽峽炎,肝腫大和眼瞼浮腫的發(fā)病率年幼兒大于年長兒,隨著年齡的增長,發(fā)病率逐漸降低。3、實驗室檢查中,白細胞、CRP、PCT、鐵蛋白升高在年長兒組比在嬰幼兒組中更為常見。血清ALT和AST的值嬰兒期組均明顯低于年長兒組,隨著年齡的增長,肝轉氨酶出現升高的趨勢。4、IM主要并發(fā)癥包括肺炎,血小板減少,中性粒細胞減少癥,和其他血液系統問題。肺炎是最常見的并發(fā)癥,肺實質損害性肺炎的發(fā)病率隨年齡增長而升高。5、存在肝功能損害的IM患者的年齡有顯著性差異,年齡越大,肝損傷的可能性越大。發(fā)病季節(jié)因素在合并肝功能損害的IM患者中有統計學差異,秋季發(fā)病率最高(81.80%),春季其次,且與夏季及冬季相比有統計學意義。病程越長,發(fā)熱時間越長,肝損傷的可能性越大,差別有統計學意義。輕度組與中度及重度組相比存在顯著性差異,考慮病情較重的患兒更易發(fā)生肝功能損害。結論1.IM的住院患兒主要是以學齡前兒童為主,3到7歲組最多。絕大多數的患兒伴有發(fā)熱、頸部淋巴結腫大和咽峽炎等臨床表現。患兒的臨床癥狀,體征,實驗室檢查結果和并發(fā)癥隨著年齡的增長而變化,但預后良好。2.IM患兒并發(fā)肝功能損害與患兒的年齡、季節(jié)、發(fā)熱持續(xù)時間、病程、病情嚴重程度有相關性。臨床上一般采用抗病毒及對癥治療。臨床上應該對于存在嚴重并發(fā)癥的病例特別注意,早期診斷與干預IM伴肝功能損害。
[Abstract]:Objective to analyze the clinical characteristics of infectious mononucleosis IM (IM) and the related factors of liver function damage in order to detect and intervene IM with liver function damage early. Methods the clinical data of 102 inpatients with IM were analyzed retrospectively. The demographic characteristics, clinical manifestations, laboratory examination and complications were analyzed statistically. The age, sex, onset season and severity of the disease were statistically analyzed in 56 cases of IM with liver dysfunction. Results the ratio of male to female was 2.29: 1 in 1102 hospitalized children. The mean age was (4.75 鹵2.82) years old. The highest incidence peak of IM was in autumn. The fever, neck lymph node enlargement and pharyngitis were typical triple sign of IM. The incidence of pharyngitis, hepatomegaly and blepharoplegia in young children is higher than that in older children. With the increase of age, the incidence rate decreases gradually. In laboratory examination, elevated levels of leukocyte and ferritin are more common in the older children than in the infants. The levels of serum ALT and AST in infancy group were significantly lower than those in older children group. With the increase of age, the main complications of hepatic aminotransferase were pneumonia, thrombocytopenia, neutropenia, and other blood system problems, and the main complications were pneumonia, thrombocytopenia, neutropenia, and other blood system problems. Pneumonia is the most common complication. The incidence of pulmonary parenchymal pneumonia increases with age. There is a significant difference in the age of IM patients with liver function damage. The older the age, the greater the likelihood of liver injury. The incidence rate in autumn was the highest (81.80%), followed in spring, and had statistical significance compared with summer and winter. The longer the course, the longer the febrile time, the greater the possibility of liver injury, the difference is statistically significant. There was significant difference between mild group and moderate and severe group. Conclusion the majority of hospitalized children with 1.IM are preschool children aged 3 to 7 years. The vast majority of children with fever, cervical lymphadenopathy and pharyngitis and other clinical manifestations. Clinical symptoms, signs, laboratory findings and complications varied with age, but the prognosis was good. 2. Liver function damage and age, season, duration of fever, course of disease in IM children. The severity of the disease is related. General clinical use of antiviral and symptomatic treatment. Special attention should be paid to the early diagnosis and intervention of IM with liver dysfunction in patients with severe complications.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.1
本文編號：2195389
[Abstract]:Objective to analyze the clinical characteristics of infectious mononucleosis IM (IM) and the related factors of liver function damage in order to detect and intervene IM with liver function damage early. Methods the clinical data of 102 inpatients with IM were analyzed retrospectively. The demographic characteristics, clinical manifestations, laboratory examination and complications were analyzed statistically. The age, sex, onset season and severity of the disease were statistically analyzed in 56 cases of IM with liver dysfunction. Results the ratio of male to female was 2.29: 1 in 1102 hospitalized children. The mean age was (4.75 鹵2.82) years old. The highest incidence peak of IM was in autumn. The fever, neck lymph node enlargement and pharyngitis were typical triple sign of IM. The incidence of pharyngitis, hepatomegaly and blepharoplegia in young children is higher than that in older children. With the increase of age, the incidence rate decreases gradually. In laboratory examination, elevated levels of leukocyte and ferritin are more common in the older children than in the infants. The levels of serum ALT and AST in infancy group were significantly lower than those in older children group. With the increase of age, the main complications of hepatic aminotransferase were pneumonia, thrombocytopenia, neutropenia, and other blood system problems, and the main complications were pneumonia, thrombocytopenia, neutropenia, and other blood system problems. Pneumonia is the most common complication. The incidence of pulmonary parenchymal pneumonia increases with age. There is a significant difference in the age of IM patients with liver function damage. The older the age, the greater the likelihood of liver injury. The incidence rate in autumn was the highest (81.80%), followed in spring, and had statistical significance compared with summer and winter. The longer the course, the longer the febrile time, the greater the possibility of liver injury, the difference is statistically significant. There was significant difference between mild group and moderate and severe group. Conclusion the majority of hospitalized children with 1.IM are preschool children aged 3 to 7 years. The vast majority of children with fever, cervical lymphadenopathy and pharyngitis and other clinical manifestations. Clinical symptoms, signs, laboratory findings and complications varied with age, but the prognosis was good. 2. Liver function damage and age, season, duration of fever, course of disease in IM children. The severity of the disease is related. General clinical use of antiviral and symptomatic treatment. Special attention should be paid to the early diagnosis and intervention of IM with liver dysfunction in patients with severe complications.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.1
【參考文獻】
相關期刊論文 前10條
1 徐士福;王孫堯;;兒童傳染性單核細胞增多癥并發(fā)肝損害患者臨床和免疫特點[J];浙江中西醫(yī)結合雜志;2017年02期
2 吳麗云;;小兒傳染性單核細胞增多癥臨床特點研究[J];中國現代藥物應用;2017年02期
3 張杰;鄧玫;王汝佳;林立麗;;不同年齡兒童傳染性單核細胞增多癥肝臟轉氨酶變化及臨床特征分析[J];肝臟;2016年10期
4 張曉芳;符佳;李亞絨;劉小乖;李瑞娜;;兒童傳染性單核細胞增多癥臨床特點分析[J];中國優(yōu)生與遺傳雜志;2016年10期
5 陳春法;張文喜;趙佳佳;高未;蔡奔奔;繆英英;;傳染性單核細胞增多癥患兒血淋巴細胞亞群及NK細胞的變化分析[J];中華醫(yī)院感染學雜志;2016年20期
6 馮林;孫昌瑞;;缺血修飾性清蛋白對傳染性單核細胞增多癥患兒心肌損傷的診斷價值[J];檢驗醫(yī)學與臨床;2016年12期
7 徐福勝;李林臣;張建偉;高洪芬;馬顯亮;劉建軍;;腺苷脫氨酶及外周血異型淋巴細胞聯合測定對小兒傳染性單核細胞增多癥的診斷價值[J];河北北方學院學報(自然科學版);2016年06期
8 龍濤;蘇秦;肖驍;于旭旭;;兒童傳染性單核細胞增多癥臨床特征分析[J];中國社區(qū)醫(yī)師;2016年15期
9 劉雪萍;王愛蘭;李佳靜;;EB病毒感染性兒童傳染性單核細胞增多癥80例臨床分析[J];陜西醫(yī)學雜志;2016年05期
10 彭俊波;陳斌斌;鄧陳華;;兒童EB病毒相關傳染性單核細胞增多癥108例臨床分析[J];熱帶醫(yī)學雜志;2015年12期
，本文編號：2195389
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2195389.html
最近更新
教材專著
