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目的:观察传染性单核细胞增多症(IM)患儿病原体分布情况及肝酶的变化。方法:分析170例初诊IM患儿EB病毒和TORCH中IgM抗体阳性分布情况及血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的水平。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,131例检出2种或2种以上病原体IgM抗体。IM患儿血清ALT、AST升高,B、C、D、E组明显高于A组(P<0.05),B、C、D和E组之间无明显差异(P>0.05)。结论:IM可由多种病原体感染引起,以混合感染为主,尤其是EB病毒与巨细胞病毒、单纯疱疹病毒的混合感染。病原体IgM抗体阳性的IM患儿血清肝酶明显高于病原体IgM抗体阴性者,但与病原体IgM抗体阳性种类的多少无关。
Objective: To observe the distribution of pathogens and the changes of liver enzymes in children with infectious mononucleosis (IM). Methods: The positive distribution of IgM antibodies and serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in Epstein-Barr virus and TORCH in 170 newly diagnosed children with IM were analyzed. Results: One hundred and seventy patients with IM, nine without pathogen IgM, 30 with one pathogen IgM and 131 with two or more pathogen IgM. The levels of ALT and AST in serum of patients with IM were significantly higher than those of group A, B, C, D and E (P <0.05). There was no significant difference between B, C, D and E groups (P> 0.05). Conclusion: IM can be caused by many kinds of pathogens, mainly mixed infections, especially the mixed infection of Epstein-Barr virus and cytomegalovirus and herpes simplex virus. Serum liver enzymes of pathogen IgM positive IM patients were significantly higher than that of pathogen IgM negative patients, but not with the number of positive IgM antibodies of pathogen.