| Objective: Through retrospective study on Infectious Mononucleosis(IM)in children,this study mainly discusses the risk factors of Infectious Mononucleosis combined with liver and heart organ function damage,so as to deepen the knowledge and understanding of the disease and facilitate the early prevention and timely treatment of the disease.Methods: Clinical data and laboratory indicators of 175 hospitalized children with IM from January 2018 to January 2021 were collected to explore the risk factors of IM combined with liver function impairment and myocardial damage.Results:1.Clinical features of children with IM: The incidence of IM in male children was higher than that in female children(1.54/1).The highest incidence was between 3and 7 years old(45.71%),followed by less than 3 years old(39.43%),and the lowest incidence was over 7 years old(14.86%).There were cases in four seasons throughout the year,with the highest incidence in spring(28.57%)and lowest in winter(19.43%).The highest incidence was in May(12.00%),followed by December(10.86%).The incidence of mycoplasma pneumoniae was the highest(84.27%)in children with IM.The main clinical symptoms were fever,lymphadenopathy and pharyngitis.Blood routine showed that the percentage of white blood cells and lymphocytes was mainly increased,and a small number of children showed decreased hemoglobin and platelet.Among the EBV antibodies,VCA-Ig M elevation was the highest(88.00%).2.The relationship between hospitalization cost and organ function impairment in patients with IM combined with liver function impairment was as follows:hospitalization cost and length of stay in children with IM combined with liver function impairment were significantly higher than those without liver impairment(P <0.05).There was no significant difference in hospitalization cost and length of stay between IM patients with myocardial damage and those without myocardial damage(P > 0.05),and there was no significant difference in hospitalization cost and length of stay between IM patients with two kinds of organ function damage(P > 0.05).3.Risk factors of liver function impairment in children with IM: The incidence of male children with IM with liver function impairment was slightly higher than that of female children(1.03/1),and there was a significant difference between the two groups(P < 0.05).Less than 3 years old had the highest incidence(39.24%),followed by 3-7years old(37.97%),and older than 7 years old had the lowest incidence(22.78%).There was significant difference with age(P < 0.05).The incidence rate was 34.18% in autumn and 18.99% in winter,and there was no significant difference between the two seasons(P > 0.05).The incidence of infection with other pathogens was higher(51.90%),and there was no significant difference(P > 0.05).The most common symptoms were fever,lymphadenomegaly and pharyngitis.There was significant difference between liver function impairment and fever,eyelid edema,lymphadenomegaly,hepatosplenomegaly and fever peak in IM children(P < 0.05),but no significant difference between IM children and pharyngitis,rash,fever days and respiratory symptoms(P > 0.05).The percentage of white blood cells,lymphocytes,platelets,CRP,EBNA-Ig G,VCA-Ig G and VCA-Ig M were significantly different in IM children complicated with liver function impairment compared with those without liver function impairment(P <0.05).There were no significant differences in PCT,erythrocyte,hemoglobin,CK-MB and EA-Ig G between the two groups(P > 0.05).Further multiple Logistic regression analysis showed that gender,age and EBNA-Ig G were independent risk factors for liver damage in infants with IM.4.Risk factors of combined myocardial damage in children with IM: The incidence of combined myocardial damage in children with IM was significantly lower than that of combined hepatic damage(0.87/1).The incidence of IM combined with myocardial damage in male children was higher than that in female children(1.76/1),but there was no significant difference(P > 0.05).The incidence rate was the highest(46.38%)between 3 and 7 years old,followed by 39.13%(39.13%)and the lowest(14.49%)between 3 and 7 years old,but there was no significant difference with age(P > 0.05).The incidence of IM patients with myocardial damage was the highest in autumn(27.54%),but there was no significant difference between them and the seasons(P > 0.05).The incidence of infection without other pathogens was higher,and the difference was significant(P<0.05).The most common symptoms were fever,lymphadenectasis,and pharyngitis,but there was no significant difference with fever,eyelid edema,lymphadenectasis,hepatosplenomegaly,peak fever,pharyngitis,rash,days of fever,and respiratory symptoms(P > 0.05).There was no significant difference in the percentage of leukocytes,lymphocytes,platelets,CRP,PCT,erythrocytes,hemoglobin,EBNA-Ig G,VCA-Ig G,VCA-Ig M,and EA-Ig G(P > 0.05).Further multiple Logistic regression analysis showed that infection with other pathogens was an independent risk factor for heart damage in IM patients.Conclusion:1.The incidence of IM was highest in spring and lowest in winter.The children were easy to be infected with other pathogens,mainly with mycoplasma pneumoniae.The main clinical symptoms were fever,lymphadenopathy and pharyngitis.Blood routine showed that the percentage of white blood cells and lymphocytes was mainly increased,and a small number of children showed decreased hemoglobin and platelet.Among the EB virus antibodies,VCA-Ig M was mainly increased.2.The hospitalization cost of IM children with liver function impairment is significantly higher.Male,younger than 3 years old,febrile,eyelid edema,hepatosplenomegaly,and moderate fever children with IM are more likely to have impaired liver function.The independent risk factors of liver function impairment in IM children were gender,age and EBNA-Ig G.3.Children with IM who were not infected with other pathogens were less likely to have myocardial damage.The independent risk factor for the complication of myocardial damage in IM children was the complication of other pathogens. |
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