Nakamura Y, Takai Y, Shimada S, Nakamura H, Tokoro A, Yamamoto T
Department of Clinical Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan.
Rinsho Byori. 1996 Jul;44(7):659-64.
We analysed the characteristics of 372 Epstein-Barr virus (EBV) infected patients visiting our hospital from 1981 to 1995 classifying the phase I (from 1981 to 1988), the phase II (from 1989 to 1991) and the phase III (from 1992 to 1995). The incidence of infectious mononucleosis (IM) as EBV primary infection increased especially in the patients over 30 years old in the phase II and III. Immunological data on EBV specific antibodies showed twice positivity for anti EBV VCA-Igm antibody and the patients with anti-EBNA antibody decreased in the phase II and III. It is indicative of early diagnosis on primary EBV infection. EBV also causes atypical diseases, non-IM in this report, including hematological or neurological disorders. In hematological ones, one of 4 cases with virus associated hemophagocytic syndrome (VAHS) took fatal courses in the phase I, others had recovered by early diagnosis and adequate therapies (pulse therapy of steroids, exchange transfusion etc.). We indicated here the increased number and advanced age of patients with IM and improvement of the early diagnosis in recent 6 years compared with the previous 8 years.
我们分析了1981年至1995年间到我院就诊的372例感染爱泼斯坦-巴尔病毒(EBV)患者的特征,将其分为三个阶段:第一阶段(1981年至1988年)、第二阶段(1989年至1991年)和第三阶段(1992年至1995年)。传染性单核细胞增多症(IM)作为EBV原发性感染的发病率在第二阶段和第三阶段尤其在30岁以上的患者中有所增加。EBV特异性抗体的免疫学数据显示,抗EBV VCA-Igm抗体的阳性率增加了两倍,而抗EBNA抗体的患者在第二阶段和第三阶段有所减少。这表明对原发性EBV感染的早期诊断。EBV还会引起非IM的非典型疾病,在本报告中包括血液学或神经系统疾病。在血液学疾病中,4例病毒相关性噬血细胞综合征(VAHS)患者中有1例在第一阶段病程致命,其他患者通过早期诊断和适当治疗(类固醇脉冲疗法、换血疗法等)康复。我们在此指出,与之前的8年相比,近6年IM患者的数量增加且年龄增大,早期诊断有所改善。