274 例青少年和成人传染性单核细胞增多症患者 肝损伤临床特征分析.

: Objective To analyze the clinical characteristics and influencing factors of liver injury in adolescents and adults with infectious mononucleosis (IM). Methods Retrospective analysis of adolescents hospitalized in Peking University First Hospital from January 1, 2005 to December 31, 2018 The liver injury characteristics of adult IM patients are divided into different subgroups according to age, serum EBV DNA level, whether they are combined with jaundice, whether they are combined with cytomegalovirus and HEV infection, and compare the differences in various indicators between the subgroups. The measurement data meets the parameters. Analysis conditions were compared with the two groups by t test, and those who did not meet the parameter analysis conditions were compared with Mann-Whitney U test between the two groups; count data between the two groups were compared by χ2 test or Fisher's exact probability method. Multivariate analysis was performed by logistic regression analysis. Results A total of 274 patients were included, including 154 males (56.2%) and 120 females (43.8%); the average age of onset was (22.3±6.7) years. Liver injury (defined as ALT>50 U/L and/or The incidence of AST>40 U/L) was 97.4% (267/274), and the incidence of jaundice was 27.6% (74/268). GGT was higher for those aged ≥20 years (Z=2.070, P=0.038). 167 patients Serum EBV DNA was detected, including 90 cases in the positive group and 77 cases in the negative group. The serum EBV DNA positive group had higher levels of GGT (Z=3.005, P=0.003) and LDH (Z=2.162, P=0.031) than the negative group. ALP was higher in the combined cytomegalovirus infection group (Z=2.351, P=0.019); GGT (Z=1.988, P=0.047) was higher in the combined HEV infection group. AST (OR=1.006, 95% CI: 1.002～1.010, P=0.005) and ALP (OR=1.012, 95% CI: 1.005～1.020, P=0.001) are independent risk factors affecting the occurrence of jaundice. Conclusion The incidence of liver injury in adolescents and adults with IM is very high, among which the elderly Liver damage is more serious in patients with serum EBV DNA positive. [ABSTRACT FROM AUTHOR]