| Objective:To analyze the characteristics of the clinical symptoms,signs,laboratory examinations,diagnosis and treatments of Infectious Mononucleosis(IM)in children.Methods: Retrospective analysis of the 138 cases of the EBV associated Infectious Mononucleosis children who were diagnosed and hospitalized in our hospital duri ng the time from June 2013 to June 2018.They were divided into three groups by a ge:the infant group(<3 years old),the preschool group(3-6 years old)and the scho ol-age group(6-14 years old).To compare the differences in symptoms,signs and la boratory examinations among the different age groups.To analyze the relationships between length of hospitalization and gender/age and ALT abnormality.To analyze the differences in some therapeutic effects of different treatments.To compare the d ifferences of sensitivity between EB virus DNA and heterotypic lymphocytes dete ction,and to analyze the relationships between EB virus DNA load and liver dysfun ction or granulocytopenia.Result:(1)Among the 138 children with IM,the preschool group was accounted fo r the largest proportion(43.48%),secondary by the infant group(41.30%).The scho ol-age group was accounted for the smallest proportion(15.22%).Male:female=1.56:1.(2)Fever(89.13%),lymphadenopathy(92.02%),angina(72.46%)were the main clin ical manifestations,accompanied by the hepatomegaly(55.8%),the splenomegaly(44.93%),the eyelid edema(53.62%),and the rash(21.74%)always.The incidence of the hepatomegaly in the preschool group was significantly higher than that in the ot her two groups(P<0.05).The incidence of the rash in the infant group was higher th an that in the other two groups(P<0.05).Mean fever time:5.9±4.34 days.The incide nce of the fever for 7 days or more was higher in the infant group(P<0.05).The co mplications:the respiratory tract infection,ALT elevations and granulocytopenia we re common complications.The complications such as anemia,thrombocytopenia,en cephalitis,and the HLH which was severe were rarer.(3)The analysis of the laborato ry examinations revealed a high incidence of the liver dysfunction(68.84%)and the granulocytopenia(22.46%).The mean white blood cell count of the infant group wa s higher than that of the preschool group and the school-age group(P<0.05).The ol der the group,the higher the incidence of the ALT elevations and the granulocytop enia(P<0.05).(4)There were no significant correlations between the length of hos pitalization of the IM children and the gender or the age(P>0.05).The length of ho spitalization was related to the degree of the ALT elevations.The higher the elevati on of ALT was,the longer the length of hospitalization was(P>0.05).(5)The treat ments:When the symptoms were severe or the complications occurred,the antivir al drugs were used in combination with glucocorticoid or gamma globulin for treat ment.There was no difference in the reduction of liver and spleen and the mean fev er time at the time of discharge between the two treatments(P>0.05).There was no difference in the reduction of liver and spleen and the recovery of liver function at the time of discharge between the treatments of the liver protection and the liver pr otection combined with the antiviral drugs in the mild patients(P>0.05).(6)The de tection sensitivity of the EB virus DNA was higher than that of the heteromorphic l ymphocytes(≧ 10%)(P<0.05).The incidence of the granulocytopenia increased w ith the increase of the EB virus DNA load(P<0.05).Conclusion:1.The EBV associated IM were most common in the preschool children,with a high er incidence in males than females,and had no obvious seasonality.2.The older the group,the higher the incidence of the fever of 7 days or more.Hepa tomegaly was mostly seen in the preschoolers,and the rash is most common in the infant group.3.The mean WBC of the infants was higher.The older the group,the higher the inc idence of the liver dysfunction and the granulocytopenia.4.The length of hospitalization was associated with the ALT elevations.5.The antiviral drugs were used in combination with the glucocorticoid or the gam ma globulin for the treatments when the symptoms were severe or the complication s occurred.There was no difference between the different treatments.There was no difference between the treatments which only used liver protection drugs and whi ch combined with the antiviral drugs except the liver protection drugs in the mild p atients.6.The detection sensitivity of EB virus DNA was higher than that of heteromorphic lymphocytes(≧10%).The incidence of the granulocytopenia increased with the in crease of EB virus DNA load. |
PDF Full Text Request