摘要
目的观察多重病原体感染的传染性单核细胞增多症(IM)患儿白细胞(WBC)计数、异常淋巴细胞(异淋)和肝酶的变化。方法分析170例初诊IM患儿EB病毒、巨细胞病毒、单纯疱疹病毒、风疹病毒和弓形虫IgM抗体阳性分布情况,观察IM患儿外周血WBC、异形淋巴细胞和血清肝酶水平的变化。结果 170例IM患儿,9例未检出病原体IgM抗体,30例检出1种病原体IgM抗体,74例检出2种病原体IgM抗体,49例检出3种病原体IgM抗体,8例检出4种病原体IgM抗体,以EB病毒、巨细胞病毒和单纯疱疹病毒IgM抗体阳性为主。IM患儿丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、WBC计数和异形淋巴细胞均明显高于健康对照组,差异有统计学意义(P均<0.01)。IM患儿A、B、C、D、E各组间两两比较,B、C、D、E组的ALT、AST、WBC计数和异形淋巴细胞均明显高于A组,差异有统计学意义(P均<0.05);B、C、D和E组之间的ALT、AST、WBC计数和异形淋巴细胞均无明显差异(P均>0.05)。结论 IM以多重感染为主,尤其是EB病毒与巨细胞病毒、单纯疱疹病毒的多重感染,多种病原体抗体联合检测可有效提高IM检出率和准确性,防止漏诊、误诊。IM患儿WBC计数、异形淋巴细胞和肝酶明显升高,升高的幅度与病原体IgM抗体的有无有关而与种类多少无关。应重视IM患儿的实验室检查以辅助诊断和指导治疗。
Objective To observe the change of the WBC count ,abnormal lymphocytes and liver enzyme in childhood - onset infectious mononucleosis （IM） with multiple infections. Methods We analyzed the distrbution of IgM antibodies in 170 IM patients. The WBC count ,abnormal lymphocytes and liver enzyme were analyzed. Results In all of the 170 patients, 9 of them didn＇t detect IgM antibody, 30 of them had one kind of IgM antibodies, 74 patients detected two kinds of IgM antibodies, 49 patients detected three kinds of IgM antibodies, 8 patients detected four kinds of IgM antibodies. The major IgM antibodies were EBV - VCA IgM, CMV IgM and HSV IgM. The levels of ALT, AST, WBC count and abnormal lymphocytes were significantly higher in IM patients compared with healthy controls（P 〈 0.05 ）. In group B, C, D and E ,the levels of ALT, AST, peripheral WBC count and abnormal lymphocytes were significantly higher than group A. But there was no significant difference among group B, C, D and group E （P 〉 0.05 ）. Conclusion Major IM patients were multiple infections, especially with EBV, CMV and HSV infection. Therefore, detection of pathogen antibodies can effectively improve the accuracy and relevance ratio. The WBC count ,abnormal lymphocytes and liver enzyme increased significantly in childhood - onset IM. The amplitude has correlation with the appearance of IgM antibody,but has no correlation with the number of IgM antibody. Laboratory examination should be attached importance in childhood - onset IM.
出处
《医学研究杂志》
2011年第3期107-110,共4页
Journal of Medical Research
