|摘要||目的 分析比较原发性EB病毒(EBV)和巨细胞病毒(CMV)合并感染的流行病学特征.方法 将208例原发性EBV和CMV合并感染患者分为4个年龄组,回顾性分析发病季节、年龄和性别分布情况,并比较4个年龄组之间的临床特征、并发症和实验室检查情况.结果 原发性EBV和CMV合并感染的高发年龄段为0～7岁和16～ 23岁.各组发热、头颈部淋巴结肿大、扁桃体咽喉炎发生率均高于80％.0～7岁组患儿肝肿大比例明显高于24～ 71岁组成人患者(79.5％∶17.6％,x2=68.500,P＜0.01),8～ 15岁组明显高于16 ～ 23岁组(73.7％∶12.7％,x2=13.500,P＜0.01)；但0～7岁组肝功能异常的比例明显低于16～23岁组(67.0％∶96.4％,x2=17.811,P＜0.01).0～7岁组白细胞明显高于24～ 71岁组,平均值分别为[(15.5±6.6)×109/L]和[(10.2±5.0)×109/L] (F=4.496,P＜0.05).0～7岁组血小板减少症的发生率明显低于16～23岁组(1.7％∶18.2％,x2=6.741,P＜0.05).0～7岁组肺炎的发生率最高,为21.4％,明显高于其他组(3组均为0％,x2=4.720、13.751、4.720,P＜0.05).结论 原发性EBV和CMV合并感染可表现为多个系统受累,儿童血液系统损害发生率比成人高,但肝功能受损的发生率比成人低.发热、头颈部淋巴结肿大、扁桃体咽喉炎等临床表现特征与传染性单核细胞增多症患者相似,并发症如肺炎则发生率更高.
Objective To analyze and compare the epidemiological characteristics of primary EB virus(EBV)and cytomegalovirus(CMV) co-infection.Methods Two hundred and eight primary EBV and CMV co-infection patients were divided into 4 age groups.The distrbution of onset season,age,sex were analyzed retrospectively,and the clinical characteristics,complications and laboratory data of 4 age groups were compared.Results The age groups with highest incidence were 0-7 years group and 16-23 years group.The incidence of fever,cervical lymphadenopathy and tonsillopharyngitis were all above 80％.The incidence of hepatomegaly in 0-7 years group was higher than that in 24-71 years group(79.5％ ∶ 17.6％,x2 =68.500,P ＜ 0.01),and the incidence in 8-15 years group was higher than that in 16-23years group(73.7％ ∶ 12.7％,x2 =13.500,P ＜ 0.01 ).But the rate of abnormal liver function in 0-7 years group was lower than that in 16-23 years group (67.0％∶％.4％,x2 =17.811,P ＜ 0.01).The mean value of WBC in 0-7 years group [(15.5 ±6.6) × 109/L] was higher than that in 24-71 years group [(10.2 ± 5.0) × 109/L] ( F =4.496,P ＜0.05).The incidence of thrombocytopenia in 0-7 years group was lower than that in 16-23 years group(1.7％ ∶ 18.2％,x2 =6.741,P ＜ 0.05).The incidence of pneumonia in 0-7 years group (21.4％) was the highest compared to other 3 groups(all of the 3 groups' incidences were 0％,x2 =4.720,13.751,4.720,P ＜ 0.05).Conclusions The primary EBV and CMV co-infection can cause multi-organ damage.The incidence of blood system damage in children is higher than adults while the incidence of liver function damage is lower than adults.Clinical characteristics such as fever,cervical lymphadenopathy and tonsillopharyngitis are similar to infectious mononucleosis,but have a higher incidence of pneumonia.|
任媛媛,赵鸿,王艳,等. 原发性EB病毒和巨细胞病毒合并感染的流行病学特征分析[J]. 国际流行病学传染病学杂志,2012,39(4):249-252.