腺样体与扁桃体肥大合并EB病毒感染患儿的流行病学分析

Epidemiological analysis of adenoid and tonsil hypertrophy combined with Epstein-Barr virus infection children

摘要:

目的 研究儿童腺样体、扁桃体肥大合并EB病毒(EBV)感染的流行病学特征。方法 从2014年1月—2024年6月河北省儿童医院出院病历中提取患儿的住院信息，对患儿性别、年龄、诊断、入院时间、临床表现、化验检查及治疗处理等进行分析。结果 收集13 206例腺样体及扁桃体肥大患儿的病历资料，其中379例(2.87%)合并EBV感染，男229例(60.42%)；女150例(39.58%)；男女比为1.5∶1，不同性别比例差异具有统计学意义(P<0.05)。各年龄段1～3、4～6、7～10、11～14岁分别占比为29.02%(110/379)、39.05%(148/379)、22.69%(86/379)、9.23%(35/379)，比例差异具有统计学意义；入院时间具有季节性，以7~9月最多。临床表现多见有发热254例(67.02%)、颈部淋巴结肿大240例(63.32%)、打鼾、张口呼吸206例(54.35%)。常见并发症主要为鼻炎/鼻窦炎134例(35.36%)；其次是肝功能异常120例(31.66%)；支气管炎/肺炎38例(10.03%)。化验检查常见有EB-PCR阳性62.01%(235/379)、总淋巴细胞免疫异常56.73%(215/379)、淋巴细胞升高且含异型淋巴细胞53.03%(201/379)。采用静脉抗病毒73.35%(278/379)、雾化激素55.67%(211/379)、口服抗过敏及鼻喷激素40.63%(154/379)等治疗。结论 在住院患儿中，腺样体、扁桃体肥大合并EBV感染具有季节、年龄特征，男性患儿住院率较高，并发症多见，临床以保守治疗为主。应采取相应措施降低儿童EBV感染的发病率，进而降低儿童扁桃体及腺样体肥大的住院率，减少其疾病负担与并发症，为儿童健康成长提供更可靠的数据。

Abstract:

Objective To investigate the epidemiological characteristics of adenoid and tonsil hypertrophy combined with Epstein-Barr virus (EBV) infection in children. Methods The hospitalization information of pediatric patients from the discharge records of Hebei Children’s Hospital between January 2014 and June 2024 was extracted, including their gender, age, diagnosis, admission time, clinical manifestations, laboratory tests, and treatment methods, etc., for analysis. Results A total of 13 206 medical records of children with adenoid and tonsil hypertrophy were collected. Among them, 379 cases (2.87%) were complicated with EBV infection, including 229 boys (60.42%) and 150 girls (39.58%). The male-to-female ratio was 1.5∶1, and the difference in gender ratio was statistically significant (P<0.05). The proportions for different age groups (1-3 years old, 4-6 years old, 7-10 years old, and 11-14 years old) were 29.02%(110/379), 39.05%(148/379), 22.69%(86/379), and 9.23%(35/379), respectively, with statistically significant differences in these proportions. The hospital admission time exhibited seasonality, with the highest number occurring between July and September. The common clinical manifestations included fever in 254 cases (67.02%), cervical lymphadenopathy in 240 cases (63.32%), snoring and mouth breathing in 206 cases (54.35%). The common complications were mainly rhinitis/sinusitis in 134 cases (35.36%), with the highest incidence; followed by liver function abnormalities in 120 cases (31.66%) and bronchitis/pneumonia in 38 cases (10.03%). The common laboratory findings included positive EBV-PCR in 62.01%(235/379), abnormal total lymphocytes in 56.73%(215/379), and elevated lymphocytes with atypical lymphocytes in 53.03%(201/379). The treatments adopted included intravenous antiviral therapy in 73.35%(278/379), nebulized corticosteroids in 55.67%(211/379), and oral anti-allergics and nasal corticosteroid sprays in 40.63%(154/379). Conclusion In hospitalized children, adenoid and tonsil hypertrophy combined with EBV infection have seasonal and age-related characteristics. Male children have a higher hospitalization rate and more complications. Clinically, conservative treatment is the main approach. Appropriate measures should be taken to reduce the incidence of EBV infection in children, thereby lowering the hospitalization rate of adenoid and tonsil hypertrophy in children, reducing their disease burden and complications, and providing more reliable data for the healthy growth of children.