传染性单核细胞增多综合征的病原学及临床特点

Etiology and clinical characteristics of infectious mononucleosislike syndrome

摘要:

目的分析传染性单核细胞增多综合征病原学构成及临床特点。方法对某院2006年1月—2013年9月住院确诊为传染性单核细胞增多综合征的87例患儿进行病原学检测，并对其临床特点进行总结。结果传染性单核细胞增多综合征居前5位的病原体是肺炎支原体（MP，20例）、巨细胞病毒（CMV,13例）、单纯疱疹病毒（HSV,11例）、衣原体（CP,11例）和细小病毒B19（HpvB19，9例）。各种病原学所致的临床表现大体相同，但各临床症状发生率有所不同。MP感染以发热及肝、脾、淋巴结大为主,且大部分合并呼吸道并发症（包括喉炎、支气管炎和肺炎等）；CMV感染也以发热、肝脾大为主，但以肝大更明显；风疹病毒感染其他症状明显，但未出现皮疹。结论传染性单核细胞增多综合征病原学多样，以MP感染最常见，其次为CMV。临床诊断应尽量查明病因，为合理抗感染治疗或去除病因治疗提供理论依据。

Abstract:

ObjectiveTo analyze the etiology and clinical characteristics of infectious mononucleosislike syndrome(IMLS).MethodsEightyseven children with IMLS in a hospital from January 2006 to September 2013 were performed pathogenic detection, then clinical features were summarized and analyzed. ResultsThe top 5 pathogens in IMLS were Mycoplasma pneumoniae (MP, n=20 ), cytomegalovirus (CMV, n=13), simplex herpes virus(HSV,n=11), Chlamydia (CP,n=11),and parvovirus B19 (Hpv B19,n=9 ), clinical manifestations of all kinds of diseases were similar, but the occurrence rates were slightly different. MP infection were mainly fever, hepatosplenomegaly, and lymphadenopathy, and most were associated with respiratory complications(including laryngitis,bronchitis,and pneumonia), CMV infection were also showed fever and hepatosplenomegaly, but the latter was more obvious; rubella patients didn’t appear skin rash, but the other symptoms were obvious. ConclusionEtiologies of infectious mononucleosislike syndrome are varied, MP infection is most common, the next is CMV. Pathogens should be ascertained to provide theoretical basis of treatment.