[1]王小鹏,王美怡,刘 芬.EB病毒相关性传染性单核细胞增多症患儿并发肝功能异常的高危因素分析[J].医学信息,2022,35(14):66-70.[doi:10.3969/j.issn.1006-1959.2022.14.014]
 WANG Xiao-peng,WANG Mei-yi,LIU Fen.Analysis of Risk Factors for Liver Dysfunction in Children with EB Virus Infectious Mononucleosis[J].Medical Information,2022,35(14):66-70.[doi:10.3969/j.issn.1006-1959.2022.14.014]
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EB病毒相关性传染性单核细胞增多症患儿并发肝功能异常的高危因素分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年14期
页码:
66-70
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
Analysis of Risk Factors for Liver Dysfunction in Children with EB Virus Infectious Mononucleosis
文章编号:
1006-1959(2022)14-0066-05
作者:
王小鹏王美怡刘 芬
(上海交通大学医学院附属第六人民医院儿科,上海 200233)
Author(s):
WANG Xiao-pengWANG Mei-yiLIU Fen
(Department of Pediatrics,Shanghai Jiaotong University School of Medicine Affiliated Sixth People’s Hospital,Shanghai 200233,China)
关键词:
EB病毒传染性单核细胞增多症肝功能异常
Keywords:
Epstein Barr virusInfectious mononucleosisAbnormal hepatic function
分类号:
R512.6
DOI:
10.3969/j.issn.1006-1959.2022.14.014
文献标志码:
A
摘要:
目的 分析EB病毒相关性传染性单核细胞增多症(EBV-IM)合并肝功能异常患儿的临床特征及高危因素。方法 回顾性分析2017年1月-2021年12月上海交通大学附属第六人民医院儿科诊断为EBV-IM的149例住院患儿临床资料,根据患儿入院时ALT的检验结果,将EBV-IM患儿分为肝功能正常组(ALT为5~64 U/L)和肝功能异常组(ALT>64 U/L),分析两组患儿临床特征,并对其高危因素进行分析。结果 149例EBV-IM患儿中肝功能异常的发生率为51.01%,≥7岁患儿发生率最高;两组性别比较,差异无统计学意义(P>0.05),肝功能异常组年龄大于肝功能正常组,差异有统计学意义(P<0.05);两组热程、淋巴结肿大、扁桃体渗出、眼睑浮肿、肝脏及脾脏肿大、皮疹比较,差异无统计学意义(P>0.05);两组白细胞总数、PCT、CRP及EBV-DNA载量比较,差异无统计学意义(P>0.05);但肝功能异常组淋巴细胞百分比及异型淋巴细胞百分比均高于肝功能正常组,差异有统计学意义(P<0.05);两组IgG、IgM水平比较,差异无统计学意义(P>0.05);但肝功能异常组IgA水平高于肝功能正常组,差异有统计学意义(P<0.05);肝功能异常组CD3+、CD8+T细胞水平高于肝功能正常组,而CD4+T细胞、CD19+B细胞水平及CD4+/CD8+比值低于肝功能正常组,差异有统计学意义(P<0.05);两组NK细胞水平比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,淋巴细胞百分比、异型淋巴细胞百分比、CD4+T细胞水平为EBV-IM并发肝功能异常的危险因素。ROC曲线分析显示,淋巴细胞、异型淋巴细胞百分比在EBV-IM并发肝功能异常的预测中的Cut-off值为58.35%、12.50%,曲线下面积为0.623、0.622,灵敏度为68.40%、44.70%,特异度为56.20%、75.30%;CD4+T细胞水平对EBV-IM并发肝功能异常无预测意义(P>0.05)。结论 EBV-IM患儿肝功能异常与细胞免疫相关,淋巴细胞百分比、异型淋巴细胞百分比、低CD4+T细胞水平为EBV-IM患儿并发肝功能异常的独立危险因素。
Abstract:
Objective To observe the clinical features and high risk factors of children with EB virus infectious mononucleosis (EBV-IM) complicated with abnormal liver function.Methods The clinical data of 149 hospitalized children with EBV-IM diagnosed in the Department of Pediatrics of the Shanghai Jiaotong University School of Medicine Affiliated Sixth People’s Hospital from January 2017 to December 2021 were retrospectively analyzed. According to the test results of ALT at admission, the children with EBV-IM were divided into normal liver function group (ALT 5-64 U/L) and abnormal liver function group (ALT>64 U/L). The clinical characteristics of the two groups were analyzed, and the risk factors were analyzed.Results The incidence of abnormal liver function in 148 children with EBV-IM was 51.01%, and the incidence of children aged ≥7 years was the highest. There was no significant difference in gender between the two groups (P>0.05). The age of the abnormal liver function group was older than that of the normal liver function group, and the difference was statistically significant ( P<0.05 ). There were no significant differences in total white blood cell count, PCT, CRP and EBV-DNA load between the two groups (P>0.05). However, the percentages of lymphocytes and atypical lymphocytes in the abnormal liver function group were higher than those in the normal liver function group, and the difference was statistically significant (P<0.05). There was no significant difference in IgG and IgM levels between the two groups (P>0.05). However, the IgA level in the abnormal liver function group was higher than that in the normal liver function group, and the difference was statistically significant (P<0.05). The levels of CD3+ and CD8+ T cell in the abnormal liver function group were higher than those in the normal liver function group, while the levels of CD4+ T cell, CD19+ B cell and CD4+/CD8+ ratio were lower than those in the normal liver function group, and the difference was statistically significant (P<0.05). There was no significant difference in NK cell level between the two groups (P>0.05). Multivariate Logistic regression analysis showed that lymphocyte percentage, atypical lymphocyte percentage and CD4+ T cell level were risk factors for EBV-IM complicated with abnormal liver function. ROC curve analysis showed that the Cut-off values of lymphocytes and atypical lymphocytes in the prediction of EBV-IM complicated with liver dysfunction were 58.35% and 12.50%, the areas under the curve were 0.623 and 0.622, the sensitivity was 68.40% and 44.70%, and the specificity was 56.20% and 75.30%. CD4+ T cell level had no significant predictive significance for EBV-IM complicated with liver dysfunction (P>0.05).Conclusion Abnormal liver function in children with EBV-IM is related to cellular immunity. Lymphocyte percentage, atypical lymphocyte percentage and low CD4+ T cell level are independent risk factors for abnormal liver function in children with EBV-IM.

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更新日期/Last Update: 1900-01-01