儿童非典型EB病毒感染的临床分析

发布时间：2018-04-30 14:40

本文选题：EB病毒 + 感染　；参考：《新疆医科大学》2013年硕士论文

【摘要】：目的：观察分析非典型EB病毒感染的患儿流行病学特点、疾病谱及血常规、肝功、心肌酶谱、细胞免疫变化，并探讨它们在儿童非典型EB病毒感染诊疗中的临床意义，以望提高早期诊断水平及针对性治疗,改善预后。方法：选取2011年3月到2012年9月于新疆医科大学住院治疗的136例非典型EB病毒感染的儿童作为观察组，回顾性分析其流行性特点、临床表现、辅助检查、治疗及转归等，并选取在门诊作健康体检的148例健康儿童作为对照组，统计各项临床资料进行对比分析。结果：EBV感染全年均可发病，冬春季节最常见;男性较女性多见;发病患儿年龄在～3岁57例,～7岁39例。主要临床症状为：咳嗽、发热、咽峡部疼痛最多见；体征：肺部罗音、咽部疱疹、肝脾肿大及水肿等。辅助检查结果：血常规外周血象白细胞总数最低0.8×10~9/L,最高47×10~9/L,平均值为(23.0±10.4)×10~9/L。WBC分类:85%以上以淋巴细胞为主(淋巴细胞百分比60%)。观察组患儿谷丙转氨酶、谷草转氨酶、羟丁酸、乳酸脱氢酶、肌酸激酶同工酶的平均值高于对照组，两组差异有统计学意义（P0.05）；非典型EBV感染组CD4+水平高于对照组，差异有统计学意义（P0.05）。最后确诊为：急性上呼吸道感染、支气管炎及肺炎、急性喉炎、淋巴结炎、心肌损害、过敏性紫癜、肾病综合征。预后及转归：经抗病毒及对症支持治疗后均预后良好。结论：儿童非典型EBV感染，以婴幼儿及学龄前患儿为主，男性多见，一年四季均可发生，冬春季节最常发生。非典型EB病毒感染可致呼吸、循环、免疫等多系统多器官损害，临床表现多种多样,可累及整个机体各个系统，呼吸系统最为常见。EBV感染后可引起肝功、心肌酶的改变；部分患儿EBV感染后存在细胞免疫的紊乱，临床上EBV感染的治疗除抗感染外，还应纠正机体免疫功能的紊乱，促进机体免疫功能恢复。
[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 卤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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R725.1

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