The Clinical Characteristics And Laboratory Analysis Of 155 Children In Hospital With EB Virus Infection

Objective:Epstein-Barr virus(EBV) generally in the crowd. After infected by EBV, our body can cause different types of diseases, their clinical feature, laboratory examination and prognosis are different, severe cases can cause some malignant diseases, such as chronic active Epstein-Barr virus infection, EB virus associated hemophagocytic syndrome, lymphocytic leukemia. So realize the danger of the virus, timely diagnosis and give the corresponding treatment is particularly important.Epstein-Barr virus infection seen more in young children for the first time, the majority of them is asymptomatic or atypical infection. Slightly dominant performance can have: upper respiratory tract infection symptoms, such as fever, nasal congestion, pharyngitis, etc, can also be associated with superficial lymph node enlargement. If children appear “fever, angina, lymph node enlargement”, it is a typical manifestation of Epstein-Barr virus infection, namely acute infection mononucleosis(IM).Because the diagnosis between IM and EB virus infection is easy to confuse, this study will discuss the characteristics of these two diseases. Methods:This study collected 155 children,s clinical date who were hospitalized in Shan Xi Province Children,s hospital in March 2013 to March 2014, including their gender, age, symptoms, signs, peripheral hemogram, the proportion of atypical lymphocyte,liver function,myocardial eneyme, inflammation index(including CRP and ESR),T lymphocyte subsets and EBV-DNA copy number, finishing their clinical date, and retrospectively analyzing. Results:Among of the 155 cases, 105 cases were diagnosed with IM, belong to IM group, while other 50 cases belong to EBV infection group. For gender and age, diagnosed with IM group(61 male and female 44 cases), male to female ratio is 1.39:1, aged 1 to 12 years old, the median age of 6.2 years, mainly for preschool children; EBV infection group(31 male and female 19 cases), the male to female ratio is 1.63:1, aged 6 months to 9 years old, the median age of 2.8 years, mainly for the children in early childhood. Both two groups more seen in men, the former for preschool age, the latter for the age of early childhood. From this study can be found: in addition to the “fever, angina, lymph node enlargement”, eyelid edema, congestion, snoring and hepatosplenomegaly are more typical in IM group.The laboratory tests have obvious difference in the two groups, in IM group, white blood cell count, lymphocyte percentage, heterotypic lymphocytes count are higher than EBV infection group; both the two groups have liver function and myocardial enzyme changes, but the enzymology change is more apparent in IM group. The cell immunity is affected in the two groups, the expression rate of CD3+, CD8+ is more higher in IM group(P﹤0.05), while CD4+, CD4+/CD8+ is lower in IM group(P﹤0.05). 155 cases with EBV-DNA are all positive, the IM group of EBV-DNA copy number in 5.58×103copies/ml to 3.16×105copies/ml, mean 1,12×104copies/ml; the EBV infection group of EBV-DNA copy number in 5.19×102copies/ml to 7.82×104copies/ml, mean 5.23×103copies/ml. Conclusion:Most of the IM is seen in preschool children, while most of the EBV infected is seen in young children in Shan Xi Province Children,s hospital. Atypical lymphocyte has important role in IM diagnose, especially dynamic monitoring, its value should be bigger. The basic pathogenesis of IM is the EBV destroy the balance of human body,s cell immune, the different degree of EB virus infection may caused different body,s immune injury. The level of EBV-DNA copy number in serum can reflect the severity of the disease and the virus activity, can be more objective understanding of the severity of patients. IM children with immune and viscera function damage easily, should antiviral treatment actively; but as a self-limited disease, EB virus infection whether can do nothing treatment, observed and wait for its limit. For better understanding a series of symptoms, signs and laboratory examination caused by EB virus, clinical doctors should be comprehensive analysis, make corresponding inspection as early as possible and reasonable treatment.