摘要
目的探讨儿童传染性单核细胞增多综合征（传单综合征）的病原学和临床特征，以便针对不同病原进行相应治疗，提高疗效和缩短疗程。方法对35例EB病毒EBV-VCA-IgM、EBV-VCA-IgA阴性而诊断为传单综合征的患儿采用ELISA方法检测患儿血清肺炎支原体抗体（MP-IgM）、巨细胞病毒抗体（CMV-Ign）、腺病毒抗体（ADV-IgM）、柯萨奇病毒抗体（CBV-IgM）、弓形虫抗体（Tox-IgM）、微小病毒抗体（B19-IgM）、乙肝病毒（HBsAg）等，并与同期住院的25例EBV感染的传染性单核细胞增多症（传单）患儿临床体征进行分析比较。结果35例传单综合征患者MP-IgM大于1：80阳性12例（34．3％），CMV-IgM阳性5例（14．3％）、ADV-IgM阳性2例（5．7％）、CBV-IgM阳性1例（5．7％）、微小病毒抗体（B19-IgM）阳性1例（5．7％）、乙肝病毒（HBsAg）阳性3例（7．9％），传单综合征组与传统的传单组在淋巴结肿大、心肌酶、白细胞计数和异常淋巴细胞比例改变明显（P〈0．05）。结论MP与CMV是引起传单综合征的最常见病因，及早明确病原并相应采用阿奇霉素、红霉素等大环内酯类药物抗支原体治疗和应用更昔洛韦抗病毒治疗均取得良好疗效。
Objective To explore etiology and clinical features of children infectious mononucleosis syndrome（IMS） and improve curative effect and shorten course of treatment by corresponding treatment according to different pathogens. Methods 35 cases of EB virus （EBV） -VCA-IgM, EBV-VCA-IgA negative were diagnosed with children infectious mononucleosis syndrome, and used ELISA method to detect their serum antibodies with mycoplasma pneumonia （MP-IgM）, cytomegalovirus （CMV-IgM）, adenovirus antibody （ADV-IgM）, Coxsackie virus antibody （CBV-IgM）, Toxoplasma antibody （Tox-IgM）, parvovirus antibody （B19-IgM） and hepatitis B virus （HBsAg）. Selected 25 cases of children infectious mononucleosis（IM） with EBV infection as control group. Results There were 12 cases of MP-IgM positive（more than 1：80）（34.3%）, 5 cases of CMV-IgM positive （14.3%）, 2 cases of ADV-IgM positive （5.7%）, 1 case of CBV-IgM positive （5.7%）, 1 case of parvovirus antibody （B 19-IgM） positive （5.7%）, 3 cases of hepatitis B virus （HBsAg） positive （7.9%） respectively in IMS group. There were significant differences in lymphadenectasis, myocardial enzymes, white blood cell count and atypical lymph cell count between IMS group and IM group（P 〈 0.05）. Conclusion MP and CMV are the most common etiology of IMS. It is important to diagnose and use azithromycin, erythromycin and other macrolides against mycoplasma and ganciclovir anti-virus as early as possible.
出处
《国际医药卫生导报》
2013年第17期2714-2717,共4页
International Medicine and Health Guidance News
