成人传染性单核细胞增多症与儿童病例临床特征的比较分析

发布时间：2018-09-18 09:58

【摘要】：目的：讨论成人与儿童传染性单核细胞增多症临床特点的差异。方法：收集2011年3月至2013年12月于重庆医科大学附属第一医院收治且诊断依据充足的传染性单核细胞增多症103例及同期于重庆医科大学儿童医院收治的306例，将其分为成人组及儿童组并针对其临床特点进行回顾性分析。其中成人组按年龄段分为7组（17岁，，17-19岁，20-22岁，23-25岁，26-28岁，29-31岁，31岁）对部分临床特点进一步比较。结果：近年来，成人患者逐渐增多。儿童主要发病年龄为7岁，共有247例（80.7%），成人组以17-25岁为主，共64例（62.1%）。成人与儿童主要临床症状相似，均为发热、咽痛、淋巴结肿大、脾大等。其中儿童发热平均时间为6.1天，成人为12.2天。成人患者咽痛高发年龄段为17-22岁，而发热、淋巴结肿大在成人各年龄段无统计学差异。并发征：肝功能损害、血液系统异常、细菌感染、肾功能不全等。成人异型淋巴细胞10%（68.0%）多于儿童（37.9%），但就白细胞升高而言，儿童（81.4%）较成人多见（57.3%）。成人肝功能异常者—ALT及AST升高4倍正常值的分别为50例（48.5%），35例（34.0%）较儿童多见（19.6%，11.4%）。成人EB-VCA-IgM检出率低下。结论：成人IM患者逐渐增多，但发病仍以儿童为主，特别是7岁。成人发病高峰在17-25岁，以女性为主。其典型症状为：发热、咽痛、淋巴结肿大、脾大。成人热程较长，异型淋巴细胞及严重肝功能异常更多见。但儿童肝大多见，肝炎发生率相对较低，WBC升高较成人明显。
[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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.1

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