English E C, Geyman J P
J Fam Pract. 1978 May;6(5):977-81.
The problem of diagnosis and appropriate treatment of patients presenting with pharyngitis is a common occurrence in family practice. The study of these patients includes laboratory tests to differentiate between infectious mononucleosis and other bacterial and viral infections. This study reviews the diagnosis of infectious mononucleosis in two large ambulatory populations, where different approaches were used. In one approach, all laboratory tests were concurrent, while in the other, serology was performed only after satisfaction of hematologic criteria for infectious mononucleosis. In the latter case, sequential use of laboratory tests resulted in a significant improvement in cost effectiveness. In both approaches, no appreciable gain was obtained from heterophil titers. Since the heterophil titer in confirmed cases of infectious mononucleosis does not correlate with prognosis or severity of the disease, this procedure can be replaced by the Monospot/"monoscreen" test alone.
咽炎患者的诊断及恰当治疗问题在家庭医疗中很常见。对这些患者的研究包括实验室检查，以区分传染性单核细胞增多症与其他细菌和病毒感染。本研究回顾了在两个大型门诊人群中对传染性单核细胞增多症的诊断，采用了不同的方法。一种方法是所有实验室检查同时进行，而另一种方法是仅在满足传染性单核细胞增多症的血液学标准后才进行血清学检查。在后一种情况下，实验室检查的序贯使用显著提高了成本效益。在两种方法中，嗜异性凝集试验效价均未取得明显益处。由于确诊的传染性单核细胞增多症病例中的嗜异性凝集试验效价与疾病的预后或严重程度无关，该检查可单独被嗜异性凝集试验/“单核细胞筛查”试验取代。
