传染性单核细胞增多症伴冠状动脉扩张病例分析

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摘要目的探索传染性单核细胞增多症（IM）合并冠状动脉扩张的病例特点。方法收集2015年5月~2016年12月于首都儿科研究所附属儿童医院确诊IM的病例，完善超声心动图检查，用Z值评估冠状动脉扩张情况，分析IM合并冠状动脉扩张病例的临床特点。结果 ①临床特点：IM共344例，伴冠状动脉扩张15例，IM合并冠状动脉扩张发病率为4.4%；年龄为（3.47±1.61）岁；男8例（53.3%），女7例（46.7%）；临床表现为发热15例（100.0%），淋巴结肿大14例（93.3%）；血常规白细胞升高14例（93.3%），淋巴细胞比例升高15例（100.0%），异型淋巴细胞比例升高14例（93.3%）；细胞免疫检查14例异常（93.3%）。②冠状动脉扩张情况：自起病至发生冠状动脉扩张所经时间中位数为5（4，8）d，冠状动脉扩张持续时间中位数为17（7，41）d；冠状动脉扩张者Z值中位数为3.74（3.01，5.64），以右侧冠状动脉扩张为主13例（86.7%）。结论 IM伴冠状动脉扩张发生于起病后1周内，病程2~3周恢复，表现为轻度右侧冠状动脉扩张，预后良好。

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	刘京晶1 郑春华2 李晓惠1 包敏2 曹爱梅2 任军2 刘波2 刘艳2

关键词 ：传染性单核细胞增多症, EB病毒, 感染, 冠状动脉

Abstract：Objective To investigate the clinical characteristics of coronary artery dilatation (CAD) of children with infectious mononucleosis (IM). Methods From May 2015 to December 2016, the cases diagnosed with IM in Children's Hospital, Capital Institute of Pediatrics were collected and performed echocardiogram. Z value was used to estimate CAD. The clinical characteristics of IM with CAD were analyzed. Results ①Clinical features: 15 children (8 boys and 7 girls) of IM with CAD among totally 344 patients were included in this study. The incidence of IM with CAD was about 4.4%. The mean age was (3.47±1.61) years. The most common clinical manifestation included fever (15 cases, 100.0%), and lymph nodes enlargement (14 cases, 93.3%). Blood routine showed leukocytosis (14 cases, 93.3%), high lymphocyte proportion (15 cases, 100.0%) and increased atypical lymphocyte ratio (14 cases, 93.3%). The disorder of cell-mediated immunity was found in 14 cases (93.3%). ②Coronary artery: the median time of CAD was 5 (4, 8) d. The median duration of CAD was 17 (7, 41) d. The median Z-score of coronary artery was 3.74 (3.01, 5.64). The right CAD was found in 13 cases (86.7%). Conclusion CAD in patients with IM can develop within 1 week after onset, and persist for about 2-3 weeks. The right CAD is the most common finding, and the prognosis is good.

Key words： Infectious mononucleosis Epstein-Barr virus Infection Coronary artery dilatation

通讯作者: 李晓惠（1968.7-），女，博士，主任医师；研究方向：儿科学心内科。

作者简介: 刘京晶（1990.3-），女，硕士；研究方向：儿科学心内科。

引用本文:

刘京晶1 郑春华2 李晓惠1 包敏2 曹爱梅2 任军2 刘波2 刘艳2 . 传染性单核细胞增多症伴冠状动脉扩张病例分析[J]. 中国医药导报, 2017, 14(29): 76-79.
LIU Jingjing1 ZHENG Chunhua2 LI Xiaohui1 BAO Min2 CAO Aimei2 REN Jun2 LIU Bo2 LIU Yan2. Case analysis of infectious mononucleosis with coronary artery dilatation. 中国医药导报, 2017, 14(29): 76-79.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I29/76

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