| Objectives The aim to the research was to analysis the Epstein Barr virus specific antibody of four different infection condition of the clinical characteristics in children with IM,including typical primary infection,early and recovery period of primary infection,reactivated infection and previous infection,which explored four diverse parts of IM with differences in clinical features,strengthened the understanding of EBV infection,and provide basis for the early prediction and early identification.Methods A total of 55 hospitalized children with IM caused by EBV infection were collected from Hebei Provincial People’s Hospital from January 2017 to December 2020.According to the presence of EBV specific antibodies at different time periods,the children with IM were divided into four groups: typical primary infection group,early and recovery stage of primary infection group,reactivated infection group,and previous infection group.The Chi-square test of R×C table was used to compare the sex distribution,age groups and different clinical manifestations among the four groups.Mann-Whitney U test and Kruskal-Wallis rank sum test were used to compare laboratory tests between two groups and between multiple groups.The general characteristics,clinical manifestations,laboratory examinations,and liver function impairment of the four groups of children with IM were retrospectively compared to provide clinical value for the early diagnosis and treatment of EBV infection.Results 1 Among the 55 hospitalized IM children,23 cases(41.8%)were boys and 32cases(58.2%)were girls,with a male to female ratio of 1:1.39.Under different infection states male and female are proved to have no statistical difference among the four groups.Children in the four groups ranged in age from 10 months to 13 years,with an average age of(5.2±3.3)years.The average age of children in the early and convalescent stages of acute infection is relatively small.The average age of the children who reactivated the infection was older.The proportion of typical primary infections was the highest in different age groups.There was no significant difference in the distribution of IM among the four groups.2 Fever,pharyngitis,cervical lymph node enlargement and other clinical manifestations were present in all the four groups of IM children.Comparison of fever and cervical lymph node enlargement under different infection states in the four groups showed no statistically significant differences in clinical manifestations such as white exudation on tonsil surface,liver enlargement,eyelid edema,cough and rash(P>0.05).There were statistically significant differences in the clinical manifestations of nasal obstruction and splenomegaly among the four groups(P<0.05).Nasal obstruction was more common in the primary and early infection,and splenomegaly is more common in reactivation infection.3In the laboratory examination,there was no significant difference in the white blood cell count,absolute lymphocyte count and percentage of heteromorphic lymphocytes among the four groups.There was no significant difference in EBV-DNA load among the four groups of IM.Alanine aminotransferase and AST/ALT were statistically significant differences in among the four groups(P<0.05),while there were no significant diversities in other indicators among the four groups.AST was distictly increased in the reactivated infection group,while AST/ALT was significantly decreased in the reactivated infection group and the other three groups.The liver function impairment was not significantly different on statistics among the four groups of IM patients(P>0.05).Compared with normal liver function,elevated alanine aminotransferase accounted for the highest proportion in the four groups under different infection states.Conclusion 1 There was no significant difference between the four groups of children with IM in different age groups and gender distribution.The proportion of typical primary infection was the highest among different age groups.2 Nasal obstruction was more common in the early stage of primary infection and in the recovery stage of IM children,while splenomegaly was more common in the reactivated infection group.3 Alanine aminotransaminase was significantly increased in children with IM under reactivated infection,while AST/ALT was significantly decreased in children with IM under reactivated infection.Figure[1];Table[6];Reference [155]... |
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