| Objective: 1.To collect and summarize the clinical characteristics of Infectious mononucleosis caused by EBV infection in children of different ages;2.To analyze the diagnostic efficacy of peripheral blood serum EBV nucleic acid load and EBV antibody detection alone or in combination.METHODS: Clinical information of children with IM caused by EBV infection hospitalized in our hospital from January 2018 to December 2020 was retrospectively studied.A total of 95 qualified cases were collected,including 59 boys(62.1%)and 36 girls(37.9%),male:female=1.64:1.According to their ages,they were divided into infant group(0~3 years old),preschool group(4~6 years old)and school age group(7~14 years old),and the clinical characteristics of children of different ages were summarized.At the same time,105non-IM children were randomly selected as the control group.Serum EBV nucleic acid load and EBV antibody were detected,and the diagnostic efficacy of the two alone or combined for IM was analyzed.Results: 1.Among the 95 cases of IM,50 cases(52.6%)were aged from 0 to 3 years which is the highest group.The incidence season was mainly in spring and autumn,and the proportion was36.9% in autumn,27.4% in spring,22.1% in summer,and 13.6% in winter.2.The clinical manifestations of the children with IM were fever(82.1%),pharyngitis(81.1%),cervical lymph node enlargement(73.7%),eyelid edema(58.9%),sleep snoring(51.6%),liver enlargement(42.1%),spleen enlargement(32.6%),rash(10.5%).Specific comparative analysis of the clinical characteristics of each age group: the incidence of 0~3 years old childrens,clinical manifestations was low;The proportion of fever and pharyngitis in4-6 years old children was higher,and there was statistical difference compared with the other two groups(P<0.05).The cervical lymph node enlargement and hepatomegaly were more prominent in 7-14 years old children,and the difference was statistically significant compared with other groups(P<0.05).The incidence of hepatosplenomegaly was positively correlated with age.3.The analysis of laboratory indicators in the acute stage of IM children showed that the percentage of leukocytes and lymphocytes were higher in children aged 0-3 years,and the percentage of atypical lymphocytes was lower,with statistical significance compared with the other two age groups(P<0.05).The percentage and positive rate of atypical lymphocytes and the CRP value in children aged 4 to 6years were slightly higher than those in the other two groups(P<0.05).4.Divide the nucleic acid capacity of serum EBV into low value,medium value and high value according to4.00E+02~4.00E+03copies/m L,4.00E+03~4.00E+04copies/m L,and4.00E+04~4.00 E copies/m L.The difference between age and load value was analyzed: the children aged 0-6 years were mainly of low load value,7-14 years were mainly of medium load value,and the proportion of high load value in all age groups was low.5.95 children with IM were tested for EBV nucleic acid and EBV antibody,and the differences between them and age were analyzed.The results showed that the positive rate of the combination of EBV nucleic acid and EBV antibody was higher than that of the single detection method in all age groups of children with IM.6.A total of 200 children in the experimental group and the control group were tested for EBV nucleic acid and EBV antibody,and the sensitivity,specificity,positive predictive value and negative predictive value of the two methods for the diagnosis of IM separately or jointly were analyzed.The results showed that: The specificity of EBV-VCA-Ig M was highest(92.4%),and the sensitivity and negative predictive value of he combination of EBV nucleic acid and EBV antibody for the diagnosis of IM were significantly increased.7.ROC curve was performed after logarithm of nucleic acid load of EBV in 95 children with IM.The results were as follows: The sensitivity was 87.4%,the specificity was 82.9%,the AUC was 0.836,the Youden index was 0.703,the cutoff value was 2.609,and the 95%confidence interval [0.777 0.893].Conclusion: 1.The results show that the nucleic acid load of EBV has high diagnostic value for IM,and the diagnostic results has certain clinical reference significance.The combined application of EBV nucleic acid and EBV antibody detection can improve the diagnosis of IM.2.There are certain differences in clinical characteristics,laboratory results and other aspects of IM caused by EBV infection in children of different ages.The clinical manifestations of the children aged 0-3 years were atypical.Fever and pharyngitis were the main symptoms and laboratory indicators of 4 to 6 years old children.From7 to 14 years old,the main manifestations were cervical lymph node enlargement and hepatosplenomegaly,with little change in laboratory indicators. |
PDF Full Text Request