成人传染性单核细胞增多症91例临床特点分析

发布时间：2018-01-16 23:35

本文关键词：成人传染性单核细胞增多症91例临床特点分析　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:分析我院感染科近4年来收治的临床诊断的成人传染性单核细胞增多症(Infectious Mononucleosis,IM)的症状、体征、实验室检查的特点,提高对该病的认识。方法:收集重庆医科大学附属第一院感染科在2012年1月~2015年12月期间符合EBV感染诊断标准的91例患者的临床数据,并对其进行回顾性分析。分析指标包括患者基本信息、发病时间、症状、体征、血液检查中淋巴细胞比例及异型淋巴细胞比例、肝功,影像学检查中胸部摄片、腹部B超等。结果:本组患者共有91例,16~25岁有53例(58.2%),男性47例(51.6%),女性46例(48.4%),夏季(6~8月)发病35例(38.5%),临床症状以三联征最常见,包括发热86例(94.5%)、咽峡炎69例(75.8%)、颈部淋巴结肿大76例(83.5%),此外,脾脏肿大55例(60.4%),皮疹17例(29.7%),肝脏肿大者5例(5.5%)。实验室检查:白细胞计数(white blood cell count,WBC)10*109/L的患者有59例(64.8%),淋巴细胞百分比35%的患者有83例(91.2%)例,50%者有64例(70.2%),异型淋巴细胞百分比10%的患者数目为76,占83.5%,转氨酶异常的病例数为83,占91.2%,高达96.7%的病人乳酸脱氢酶(lactate dehydrogenase,LDH)升高,EB病毒衣壳抗原IgM抗体(Epstein-Barr virus Virus Capsid Antigen IgM,EBV-VCA-IgM)的阳性率为71.4%。治疗上予以抗病毒及对症支持,大多预后良好,仅有一例重症病例,发展为及吉雷-巴特综合征(Guillain-Barre Syndrome,GBS)。结论:成人IM患者的症状和阳性体征及实验室检查结果较为多样,临床医生应加深对IM临床特点的认识,以降低误诊率和漏诊率,防治并发症。
[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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R512.7

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