摘要
目的探讨成人EB病毒感染相关性疾病的临床特征及预后。方法回顾性分析2017年1月至2019年8月于上海复旦大学附属华山医院住院的59例EB病毒感染相关性疾病患者的临床资料。比较传染性单核细胞增多症(infectious mononucleosis,IM)、慢性活动性EB病毒感染(chronic active Epstein-Barr virus infection,CAEBV)和淋巴瘤患者的临床表现。将患者分为急性病程组(IM)和慢性病程组(CAEBV^(+)淋巴瘤),比较2组患者的实验室指标(血常规、肝功能、炎症指标、EB病毒DNA、EB病毒抗体和T淋巴细胞)检查结果。统计学处理采用曼-惠特尼U检验、χ^(2)检验或Fisher确切概率法。结果59例EB病毒感染相关性疾病患者中,IM 23例(39.0%),淋巴瘤23例(39.0%),CAEBV 13例(22.0%);发热57例(96.6%),淋巴结肿大37例(62.7%)、脾大36例(61.0%)。慢性病程组有17例患者合并噬血细胞性淋巴组织细胞增生症(hemophagocytic lymphohistiocytosis,HLH)。慢性病程组患者的白细胞计数、血红蛋白、血小板计数分别为4.07(1.94,8.35)×10^(9)/L、89.5(74.5,108.0)g/L、100(37,161)×10^(9)/L,分别低于急性病程组的9.91(6.75,17.38)×10^(9)/L、132.5(118.2,152.0)g/L、197(129,233)×10^(9)/L,差异均有统计学意义(U=3.69、5.22、3.61,均P<0.01)。慢性病程组患者的降钙素原、C反应蛋白、血清铁蛋白分别为0.45(0.15,1.13)μg/L、47.75(17.57,84.67)mg/L、2000(682,2002)μg/L,分别高于急性病程组的0.12(0.07,0.28)μg/L、6.39(3.13,11.38)mg/L、482(159,1271)μg/L,差异均有统计学意义(U=-2.95、-3.77、-4.16,均P<0.01)。慢性病程组患者的CD4^(+)T淋巴细胞计数、CD8^(+)T淋巴细胞计数、CD19^(+)B淋巴细胞计数、自然杀伤细胞计数分别为259.15(101.98,509.26)、214.69(119.31,529.47)、46.14(4.44,135.87)和81.09(41.53,118.46)/μL,分别低于急性病程组的738.88(592.20,893.94)、1609.17(920.88,3952.34)、144.52(83.65,215.14)和309.82(123.78,590.68)/μL,差异均有统计学意义(U=3.66、3.80、2.90、3.40,
Objective To investigate the clinical characteristics and prognosis of Epstein-Barr virus-related diseases in adults.Methods The clinical data of 59 patients with Epstein-Barr virus-related diseases in Huashan Hospital,Fudan University,Shanghai from January 2017 to August 2019 were analyzed retrospectively.The clinical manifestations of patients with infectious mononucleosis(IM),chronic active Epstein-Barr virus infection(CAEBV)and lymphoma in patients were compared.Patients were divided into acute course group(IM)and chronic course group(CAEBV^(+)lymphoma),and the results of labratory indications(blood rontine,liver function,imflammatory indications,Epstein-Barr virus DNA,Epstein-Barr virus antibody and T lymphocyte)were compared between two groups.Statistical analysis was performed by Mann-Whitney U test,chi-square test or Fisher exact probability test.Results Among the 59 patients,23 cases(39.0%)were diagnosed with IM,23 cases(39.0%)were lymphoma and 13 cases(22.0%)were CAEBV.The clinical manifestations of patients with Epstein-Barr virus-related diseases were fever(57/59,96.6%),lymphadenopathy(37/59,62.7%)and splenomegaly(36/59,61.0%).There were 17 patients in the chronic course group experienced hemophagocytic lymphohistiocytosis(HLH).The white blood cell counts,hemoglobin levels and platelet counts of patients in the chronic course group(4.07(1.94,8.35)×10^(9)/L,89.5(74.5,108.0)g/L and 100(37,161)×10^(9)/L,respectively)were all lower than those in the acute course group(9.91(6.75,17.38)×10^(9)/L,132.5(118.2,152.0)g/L and 197(129,233)×10^(9)/L,respectively),with statistically significant differences(U=3.69,5.22 and 3.61,respectively,all P<0.01).The levels of procalcitonin,C-reactive protein and serum ferritin in the chronic course group(0.45(0.15,1.13)μg/L,47.75(17.57,84.67)mg/L and 2000(682,2002)μg/L,respectively)were all higher than those in the acute course group(0.12(0.07,0.28)μg/L,6.39(3.13,11.38)mg/L and 482(159,1271)μg/L,respectively),with statistically significant differences(U=-2.95,-3.77 an
作者
杨小舟
杨清銮
陈宇明
刘爱平
郑建铭
屠燕婕
虞胜镭
李荣宽
邵凌云
张文宏
Yang Xiaozhou;Yang Qingluan;Chen Yuming;Liu Aiping;Zheng Jianming;Tu Yanjie;Yu Shenglei;Li Rongkuan;Shao Lingyun;Zhang Wenhong(Department of Infectious Diseases,Second Hospital of Dalian Medical University,Dalian 116023,China;Department of Infectious Diseases,Huashan Hospital,Fudan University,Shanghai 200040,China;Clinical Lab,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Febrile Disease,Basic Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中华传染病杂志》
CAS
CSCD
2021年第3期163-167,共5页
Chinese Journal of Infectious Diseases
基金
国家自然科学基金(81904072)。
关键词
EB病毒
成年人
慢性活动性EB病毒感染
淋巴瘤
临床特征
Epstein-Barr virus
Adult
Chronic active Epstein-Barr virus infection
Lymphoma
Clinical characteristics
