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目的 探讨传染性单核细胞增多症(infectious mononucleosis,IM)患儿Epstein-Barr病毒(Epstein-Barrvirus,EBV)-DNA载量、外周血细胞比值[包括中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)、单核细胞/淋巴细胞比值(monocyte-to-lymphocyte ratio, MLR)]与临床特征及预后的相关性，为早期病情评估及预后预测提供依据。方法 采用单中心回顾性病例分析，纳入2020年7月至2024年6月在濮阳市人民医院儿科诊治的90例IM患儿，收集患儿一般资料、临床特征、实验室指标(EBV-DNA载量、NLR、MLR、肝功能)及预后指标(住院时间、并发症)。通过独立样本t检验、χ2检验分析组间差异，Pearson/Spearman相关性分析评估指标与预后的相关性，采用Logistic回归分析筛选并发症的独立危险因素。结果 90例患儿中，男52例(57.78%)，女38例(42.22%)，平均年龄(6.82±2.31)岁；EBV-DNA载量中位数为4.40 lg copies/mL。高载量组(≥4.40 lg copies/mL)患儿发热持续时间、肝脾肿大程度及丙氨酸氨基转移酶/天门冬氨酸氨基转移酶水平显著高于低载量组(P<0.001)，并发症发生率显著升高(35.56%vs. 11.11%,P=0.012)高比值组(NLR≥2.15或MLR≥0.32)患儿发热持续时间、淋巴结肿大数目及肝肿大程度显著高于低比值组(P<0.005)，且EBVDNA载量更高(P=0.004)。相关性分析显示，EBV-DNA载量、NLR、MLR与住院时间及并发症均呈正相关(P<0.05)。Logistic回归分析显示，EBV-DNA载量(OR=2.154,95%CI:1.321～3.512)和NLR(OR=1.876,95%CI:1.123～3.135)是并发症的独立危险因素(P<0.05)。结论 IM患儿中，高EBV-DNA载量及高NLR/MLR与更严重的临床特征及不良预后相关，EBV-DNA载量和NLR可作为并发症的独立预测指标，为早期风险分层提供参考。
Abstract：Objective To analyze the correlation of Epstein-Barr virus(EBV)-DNA load and peripheral blood cell ratios [neutrophil-to-lymphocyte ratio(NLR), monocyte-to-lymphocyte ratio(MLR)] with clinical features and prognosis in children with infectious mononucleosis(IM), and to provide evidence for early disease assessment and prognosis prediction. Methods A single-center retrospective case analysis was conducted, including 90 children with IM who were treated in the Pediatrics Department of Puyang People's Hospital from July 2020 to June 2024. General data, clinical features, laboratory indicators(EBV-DNA load, NLR, MLR, liver function), and prognostic indicators(hospitalization duration, complications) were collected. Independent sample t-test and chi-square test were used for intergroup comparisons, Pearson/Spearman correlation analysis was performed to evaluate the correlation between indicators and prognosis, and Logistic regression was applied to screen independent risk factors for complications. Results Among the 90 patients, 52(57.78%) were male and 38(42.22%) were female, with a mean age of(6.82±2.31) years. The median EBV-DNA load was 4.40 lg copies/mL. In the high viral load group(≥4.40 lg copies/mL), the duration of fever, degree of hepatosplenomegaly, and ALT/AST levels were significantly higher than those in the low viral load group(P<0.001), and the incidence of complications(35.56% vs. 11.11%) was significantly increased(35.56% vs. 11.11%, P=0.012). The high-ratio group(NLR≥2.15 or MLR≥0.32) had significantly longer fever duration, more lymph node enlargement, and more severe hepatomegaly than the low-ratio group(P<0.005), with a higher EBV-DNA load(P=0.004). Correlation analysis revealed positive correlations between EBV-DNA load, NLR, MLR and both hospitalization duration and complications(P<0.05). Logistic regression indicated that EBV-DNA load(OR=2.154, 95%CI: 1.321-3.512) and NLR(OR=1.876, 95%CI: 1.123-3.135) were independent risk factors for complications(P<0.05). Conclusion In pediatric IM, high EBV-DNA load and high NLR/MLR are associated with more severe clinical phenotypes and poor prognosis. EBVDNA load and NLR can serve as independent predictors of complications, providing references for early risk stratification.
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基本信息:
中图分类号:R725.1
引用信息:
[1]张永卓,王鹏,栾晓飞.传染性单核细胞增多症患儿的EBV-DNA载量、外周血细胞比值与临床特征及预后的相关性分析[J].传染病信息,2026,39(02):182-186.
2026-04-30
2026-04-30