Analysis of early risk factors for infectious mononucleosis in children from Chengdu city

doi:10.3969/j.issn.1004-583X.2023.11.008

Abstract

Abstract:

Objective To analyze the different clinical manifestations and early laboratory risk for infectious mononucleosis (IM) in children caused by Epstein-Barr (EB) virus infection, EB virus infection combined with Mycoplasma pneumoniae (MP), EB virus infection combined with human cytomegalovirus (CMV) infection and EB virus infection combined with MP and CMV infection. Methods From October 2015 to April 2023, totally 163 children with IM patients and positive for EB virus who were admitted or first diagnosed in Chengdu Second People's Hospital were recruited. Among them, IM patients with EB virus infection were included in the experimental group, and those with EB virus infection combined with MP infection were included in the control group 1; those with EB virus infection combined with CMV infection were included in the control group 2; and those with EB virus infection combined with MP and CMV infection were included in the control group 3. Gender, age and clinical symptoms of children were collected, and the early laboratory indicators of infection were detected for statistical analyses. Results There were no significant differences in gender, age and incidence of clinical symptoms like fever, tonsil enlargement and lymph node enlargement among the four groups ( $P$ >0.05). Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and glutamyl transpeptidase (GGT) of the experimental group were significantly higher than those of the control group 1 ( $P$ <0.05). GGT of the experimental group was significantly higher than that of the control group 2( $P$ <0.05). ALT and GGT of the experimental group were significantly higher than those of the control group 3 ( $P$ <0.05). Conclusion The clinical symptoms of EB virus infection in children with IM are similar to those with the co-infection, but presenting severer liver function impairment. An early routine detection of risk factors for liver function favors early clinical diagnosis and treatment and thus improves the prognosis.

Key words: infectious mononucleosis, Epstein-Barr virus, human cytomegalovirus, mycoplasma pneumonia, risk indicators

CLC Number:

R512.7

Nie Fang, Luo Jun. Analysis of early risk factors for infectious mononucleosis in children from Chengdu city[J]. Clinical Focus, 2023, 38(11): 1008-1011.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.11.008

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I11/1008

Figures/Tables 1

Tab. 1 Comparison of clinical data and laboratory index between groups([ x -±s],n[%])

组别		例数	年龄(岁)			发热		扁桃体肿大			淋巴结肿大		N(%)		WBC(×10⁹/L)		HL(%)
单纯EB病毒感染组		71	6.27±4.41			64(90.14)		67(94.37)			64(90.14)		28.13±9.88		14.56±5.04		19.31±10.65
EB合并MP感染组		33	6.38±3.73			29(87.88)		32(96.97)			32(96.97)		23.08±7.23		16.84±6.81		18.23±12.04
EB合并CMV感染组		30	4.80±1.81			27(90.00)		30(100.00)			28(93.33)		27.99±10.25		16.85±6.83		22.90±11.99
EB合并MP+CMV感染组		29	5.11±2.76			28(96.55)		29(100.00)			27(93.10)		22.99±9.48		16.53±6.18		23.44±16.52
$F$ /χ²值			1.768			1.545		3.440			0.789		1.357		0.988		1.508
$P$ 值			0.155			0.672		0.329			0.852		0.262		0.403		0.215
组别		C-RP(mg/L)			ALT(U/L)				AST(U/L)			DBIL(μmol/L)		TBIL(μmol/L)		ALP(U/L)
单纯EB病毒感染组		10.52±12.42			112.80±105.18				85.59±81.28			2.48±1.96		6.65±3.51		252.76±121.78
EB合并MP感染组		14.24±21.89			49.33±29.28*				59.07±20.82			1.95±1.06		5.83±2.26		244.54±77.04
EB合并CMV感染组		14.25±22.47			60.50±45.29*				61.10±41.17			2.35±0.73		7.20±1.69		236.50±58.50
EB合并MP+CMV感染组		13.45±13.00			59.14±29.60*				46.00±16.03*			2.33±1.17		7.36±3.37		201.29±30.57
$F$ /χ²值		0.578			7.859				3.979			0.217		0.042		0.011
$P$ 值		0.631			0.001				0.014			0.642		0.838		0.918
组别	GGT(U/L)			Mb(μg/L)			CK-MB(μg/L)			HsTnl(μg/L)			CK(U/L)		HBDH(U/L)		LDH(U/L)
单纯EB病毒感染组	54.98±71.25			15.20±7.59			1.82±1.98			0.004±0.003			74.86±40.45		413.69±102.92		526.83±132.51
EB合并MP感染组	25.67±14.09^*			11.62±10.75			1.40±1.56			0.005±0.005			68.89±57.26		407.89±73.36		531.44±96.94
EB合并CMV感染组	15.89±8.34^*			12.89±12.42			1.54±1.43			0.006±0.005			62.56±26.99		371.33±42.74		468.22±174.96
EB合并MP+CMV感染组	13.43±6.24^*			16.45±11.95			2.40±2.55			0.005±0.004			51.50±47.42		431.00±83.26		481.50±181.32
$F$ /χ²值	8.081			1.597			1.584			1.846			2.105		2.674		1.775
$P$ 值	0.001			0.192			0.195			0.141			0.102		0.061		0.154

Tab. 1 Comparison of clinical data and laboratory index between groups([ x -±s],n[%])

组别		例数	年龄(岁)			发热		扁桃体肿大			淋巴结肿大		N(%)		WBC(×10⁹/L)		HL(%)
单纯EB病毒感染组		71	6.27±4.41			64(90.14)		67(94.37)			64(90.14)		28.13±9.88		14.56±5.04		19.31±10.65
EB合并MP感染组		33	6.38±3.73			29(87.88)		32(96.97)			32(96.97)		23.08±7.23		16.84±6.81		18.23±12.04
EB合并CMV感染组		30	4.80±1.81			27(90.00)		30(100.00)			28(93.33)		27.99±10.25		16.85±6.83		22.90±11.99
EB合并MP+CMV感染组		29	5.11±2.76			28(96.55)		29(100.00)			27(93.10)		22.99±9.48		16.53±6.18		23.44±16.52
$F$ /χ²值			1.768			1.545		3.440			0.789		1.357		0.988		1.508
$P$ 值			0.155			0.672		0.329			0.852		0.262		0.403		0.215
组别		C-RP(mg/L)			ALT(U/L)				AST(U/L)			DBIL(μmol/L)		TBIL(μmol/L)		ALP(U/L)
单纯EB病毒感染组		10.52±12.42			112.80±105.18				85.59±81.28			2.48±1.96		6.65±3.51		252.76±121.78
EB合并MP感染组		14.24±21.89			49.33±29.28*				59.07±20.82			1.95±1.06		5.83±2.26		244.54±77.04
EB合并CMV感染组		14.25±22.47			60.50±45.29*				61.10±41.17			2.35±0.73		7.20±1.69		236.50±58.50
EB合并MP+CMV感染组		13.45±13.00			59.14±29.60*				46.00±16.03*			2.33±1.17		7.36±3.37		201.29±30.57
$F$ /χ²值		0.578			7.859				3.979			0.217		0.042		0.011
$P$ 值		0.631			0.001				0.014			0.642		0.838		0.918
组别	GGT(U/L)			Mb(μg/L)			CK-MB(μg/L)			HsTnl(μg/L)			CK(U/L)		HBDH(U/L)		LDH(U/L)
单纯EB病毒感染组	54.98±71.25			15.20±7.59			1.82±1.98			0.004±0.003			74.86±40.45		413.69±102.92		526.83±132.51
EB合并MP感染组	25.67±14.09^*			11.62±10.75			1.40±1.56			0.005±0.005			68.89±57.26		407.89±73.36		531.44±96.94
EB合并CMV感染组	15.89±8.34^*			12.89±12.42			1.54±1.43			0.006±0.005			62.56±26.99		371.33±42.74		468.22±174.96
EB合并MP+CMV感染组	13.43±6.24^*			16.45±11.95			2.40±2.55			0.005±0.004			51.50±47.42		431.00±83.26		481.50±181.32
$F$ /χ²值	8.081			1.597			1.584			1.846			2.105		2.674		1.775
$P$ 值	0.001			0.192			0.195			0.141			0.102		0.061		0.154

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