探讨EB病毒(EBV)抗体阳性儿童患者流行病学和临床特征。

收集2014年1月至2016年12月于重庆市第九人民医院儿童呼吸科就诊的2 073例住院患儿，依据EBV壳抗原(EBV-VCA)抗体情况分为4组：EBV-VCA IgM(＋)/IgG(＋)(n＝68)、EBV-VCA IgM(＋)/IgG(－)(n＝133)、EBV-VCA IgM(－)/IgG(＋)(n＝692)、EBV-VCA IgM(－)/IgG(－)(n＝1 180)，收集患儿的临床资料并做回顾性分析。

2 073例患儿EBV-VCA总体阳性率为43.08%(893/2 073)。不同EBV-VCA抗体阳性组间的年龄、性别、季节分布，均差异有统计学意义(χ²＝70.69，12.22，17.39；均P<0.05)。本研究中EBV抗体阳性患儿临床表现以发热(75.70%，676/893)、咳嗽(59.35%，530/893)、咽峡炎(48.26%，431/893)等症状多见。819例患儿进行肝功能检查，有12.58%(103/819)患儿血清丙氨酸氨基转移酶(ALT)水平升高，30.40%(249/819)患儿血清天门冬氨酸氨基转移酶(AST)水平升高；747例患儿进行血清肌酸激酶同工酶(CK-MB)检查，其中388例(51.94%)水平升高。在EBV-VCA IgM和IgG均阳性与仅EBV-VCA IgM阳性两组中，具备典型传染性单核细胞增多症(IM)表现患儿比例分别为61.76%(42/68)、65.41%(87/133)，与仅EBV-VCA IgG阳性组(35.40%，245/692)比较，均差异有统计学意义(χ²＝18.31，47.78；均P<0.01)。

EBV感染在各年龄阶段、各季节均可发生，且临床表现无特异性，因此，EBV感染应引起家长及医疗工作者的重视。

To investigate the epidemiological and clinical features of children with positive antibody to Epstein-barr virus.

From January 2014 to December 2016, 2 073 hospitalized children were divided into 4 groups according to the situation of EBV shell antigen (EBV-VCA) antibody: EBV-VCA IgM(+ )/IgG(+ )(n=68), EBV-VCA IgM(+ )/IgG(-)(n=133), EBV-VCA IgM(-)/IgG(+ )(n=692), EBV-VCA IgM(-)/IgG(-)(n=1 180), clinical data of children were collected and retrospectively analyzed.

The overall positive rate of EBV-VCA in 2 073 children was 43.08% (893/2 073). There were significant differences in age, sex and seasonal distribution among different EBV-VCA antibody positive groups(χ²=70.69, 12.22, 17.39, all P<0.05). In this study, fever(75.70%, 676/893), cough(59.35%, 530/893)and pharyngitis(48.26%, 431/893) were the most common clinical manifestations in children with positive EBV antibody.Liver function was examined in 819 children, the serum alanine aminotransferase (ALT) level increased in 12.58% (103/819) children and the serum aspartate aminotransferase (AST) level increased in 30.40%(249/819) children. Serum creatine kinase isoenzyme (CK-MB) was examined in 747 children, and the level of CK-MB increased in 388 cases (51.94%). In both EBV-VCA IgM and IgG positive and only EBV-VCA IgM positive groups, the proportion of children with typical infeetious mononucleosis (IM) manifestation was significantly higher than that in only EBV-VCA IgG positive group(61.76% vs 35.40%, 65.41% vs 35.40%, χ²=18.31, 47.78, all P<0.01).

EBV infection can occur in all ages and seasons in children, and its clinical manifestation is not specific. Therefore, parents and pediatricians should pay attention to EBV infection.