【摘要】：目的：討論成人與兒童傳染性單核細(xì)胞增多癥臨床特點的差異。 方法：收集2011年3月至2013年12月于重慶醫(yī)科大學(xué)附屬第一醫(yī)院收治且診斷依據(jù)充足的傳染性單核細(xì)胞增多癥103例及同期于重慶醫(yī)科大學(xué)兒童醫(yī)院收治的306例，將其分為成人組及兒童組并針對其臨床特點進行回顧性分析。其中成人組按年齡段分為7組（17歲，，17-19歲，20-22歲，23-25歲，26-28歲，29-31歲，31歲）對部分臨床特點進一步比較。 結(jié)果：近年來，成人患者逐漸增多。兒童主要發(fā)病年齡為7歲，共有247例（80.7%），成人組以17-25歲為主，共64例（62.1%）。成人與兒童主要臨床癥狀相似，均為發(fā)熱、咽痛、淋巴結(jié)腫大、脾大等。其中兒童發(fā)熱平均時間為6.1天，成人為12.2天。成人患者咽痛高發(fā)年齡段為17-22歲，而發(fā)熱、淋巴結(jié)腫大在成人各年齡段無統(tǒng)計學(xué)差異。并發(fā)征：肝功能損害、血液系統(tǒng)異常、細(xì)菌感染、腎功能不全等。成人異型淋巴細(xì)胞10%（68.0%）多于兒童（37.9%），但就白細(xì)胞升高而言，兒童（81.4%）較成人多見（57.3%）。成人肝功能異常者—ALT及AST升高4倍正常值的分別為50例（48.5%），35例（34.0%）較兒童多見（19.6%，11.4%）。成人EB-VCA-IgM檢出率低下。 結(jié)論：成人IM患者逐漸增多，但發(fā)病仍以兒童為主，特別是7歲。成人發(fā)病高峰在17-25歲，以女性為主。其典型癥狀為：發(fā)熱、咽痛、淋巴結(jié)腫大、脾大。成人熱程較長，異型淋巴細(xì)胞及嚴(yán)重肝功能異常更多見。但兒童肝大多見，肝炎發(fā)生率相對較低，WBC升高較成人明顯。
[Abstract]:Objective: to discuss the clinical characteristics of infectious mononucleosis in adults and children. Methods: 103 cases of infectious mononucleosis treated in the first affiliated Hospital of Chongqing Medical University from March 2011 to December 2013 and 306 cases treated in the Children's Hospital of Chongqing Medical University were collected. The patients were divided into adult group and children group and their clinical characteristics were analyzed retrospectively. The adult group was divided into 7 groups according to their age groups (17 to 19 years old and 20 to 22 years old and 23 to 25 years old and 26 to 28 years old and 29 to 31 years old). Results: in recent years, adult patients gradually increased. The main onset age of children was 7 years old, 247 cases (80.7%), and 64 cases (62.1%) in adult group were 17-25 years old. The main clinical symptoms of adults and children were similar, including fever, pharynx, lymphadenopathy and splenomegaly. The average time of fever was 6.1 days for children and 12.2 days for adults. The high incidence of pharyngitis in adults was 17-22 years old, while fever and lymphadenopathy had no statistical difference in all age groups. Complications: liver dysfunction, abnormal blood system, bacterial infection, renal insufficiency, etc. The percentage of abnormal lymphocytes in adults was 10% (68.0%) more than that in children (37.9%). However, in terms of leukocytosis, children (81.4%) were more common than adults (57.3%). The normal values of -alt and AST in adults with abnormal liver function were 50 cases (48.5%) and 35 cases (34.0%) respectively, which were more common than those in children (19.6%). The detection rate of EB-VCA-IgM in adults was low. Conclusion: adult patients with IM increased gradually, but the incidence was still mainly in children, especially in 7 years old. Adult incidence peak in 17-25 years old, mainly female. Its typical symptoms are fever, pharynx, lymphadenopathy and splenomegaly. Adult fever is longer, abnormal lymphocytes and severe liver function is more common. But the incidence of hepatitis was relatively low and WBC was higher in children than in adults.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R725.1

【參考文獻】

相關(guān)期刊論文 前8條

1 高全杰;史忠;鄧小飛;尹揚光;;成人傳染性單核細(xì)胞增多癥的臨床研究[J];重慶醫(yī)學(xué);2010年15期

2 吳菲;蔣利萍;;重癥傳染性單核細(xì)胞增多癥危險因素分析[J];保健醫(yī)學(xué)研究與實踐;2012年01期

3 李志瑤;舒敏;;糖皮質(zhì)激素治療傳染性單核細(xì)胞增多癥的系統(tǒng)評價[J];兒科藥學(xué)雜志;2012年08期

4 田文俠;姚忠強;邢雪梅;黃建玲;應(yīng)海燕;李志敏;劉蕾;;異型淋巴細(xì)胞比例與EB病毒現(xiàn)癥感染相關(guān)性分析[J];航空航天醫(yī)藥;2009年01期

5 呂潔;金蓮花;孫景輝;樸金花;;兒童傳染性單核細(xì)胞增多癥臨床特點與發(fā)病年齡的關(guān)系:附312例分析[J];臨床兒科雜志;2011年06期

6 岑丹陽;陳純;薛紅漫;;兒童傳染性單核細(xì)胞增多癥238例臨床分析[J];中國熱帶醫(yī)學(xué);2008年04期

7 謝正德;;兒童EB病毒傳染性單核細(xì)胞增多癥臨床特征及診斷標(biāo)準(zhǔn)[J];實用兒科臨床雜志;2007年22期

8 謝楊新;秦恩強;李文剛;許文;徐哲;張昕;周志平;陳威巍;聶為民;趙敏;;成人傳染性單核細(xì)胞增多癥患者56例臨床及實驗室特征分析[J];疑難病雜志;2013年07期

本文編號：2247547