儿童非嗜肝性病毒感染性肝损害患者病因与转归分析*

doi:10.3969/j.issn.1672-5069.2025.04.012

摘要/Abstract

摘要： 目的分析总结儿童非嗜肝性病毒感染性肝损害患者的病因和诊治经过,为临床诊治该类疾病提供经验。方法 2022年1月～2023年12月我院收治的非嗜肝性病毒感染性肝损害患儿102例,使用采用7300型实时荧光定量PCR仪及其配套试剂盒检测EBV DNA和手足病病毒亚型RNA病毒载量,给予降酶等护肝和对症治疗。结果在102例非嗜肝性病毒感染性肝损害患儿中,病因包括呼吸道感染43例(41.7%)、腹泻病32例(31.1%)、传染性单核细胞增多症10例(9.7%)、药物性肝损伤9例(8.8%)和手足口病8例(7.8%);发热58例(56.9%),腹泻37例(36.3%),咳嗽33例(32.4%),恶心呕吐27例(26.5%),纳差17例(16.7%),皮肤瘙痒3例(2.9%);肝肿大26例(25.5%),淋巴结肿大21例(20.6%),扁桃体肿大19例(18.6%),脾肿大13例(12.8%),皮疹8例(7.8%)和眼睑水肿6例(5.9%);在治疗7～18 天(平均2周)后,肝功能正常73例(71.6%),另29例(28.4%)继续护肝治疗至4～6周(平均5周),肝功能全部恢复正常。结论非嗜肝性病毒感染性肝损害患儿主要病因为呼吸道、肠道感染和传染性单核细胞增多症,在护肝治疗后,大多预后良好。

关键词: 非嗜肝性病毒感染, 肝损害, 病因, 治疗, 儿童

Abstract: Objective The aim of this study was to summarize etiology and prognosis of children with non-hepatophilic viral infection with liver injury. Method 102 children with non-hepatotropic virus infection-induced liver injury were encountered in our hospital between January 2022 and December 2023, serum viral RNA loads were assayed by RT-PCR, and liver-protecting procedures were given. Result Of 102 children with non-hepatotropic virus infection-induced liver injury, the etiologies included respiratory tract infection in 43 cases (41.7%), gut infections in 32 cases (31.1%), infectious mononucleosis in 10 cases (9.7%), drug-induced liver injury (DILI) in 9 cases (8.8%)and hand-foot-mouth disease in 8 cases(7.8%); fever in 58 cases (56.9%), diarrhea in 37 cases (36.3%), cough in 33 cases (32.4%), nausea and vomiting in 27 cases (26.5%), anorexia in 17 cases (16.7%), itching in 3 cases(2.9%); hepatomegaly in 26 cases (25.2%), lymphadenopathy in 21 cases (20.6%), tonsillitis in 19 cases (18.6%), splenomegaly in 13 cases (12.8%), rash in 8 cases (7.8%) and eyelid edema in 6 cases (5.9%); liver function tests recovered at 7 to 18 days, averaged in two weeks, in 73 cases (71.6%), and other 29 children (28.4%) got their liver function tests normal after 4 to 6 (average 5) week treatment. Conclusion The common causes of liver damage in children with non-hepatotropic virus infection are mainly respiratory tract, intestinal infection, and infectious mononucleosis. The overall prognosis of children with non-hepatotropic virus infection-induced liver injury is good as protecting liver function treatment is given.

Key words: Non-hepatophilic virus infection, Liver injury, Etiology, Diagnosis and treatment, Children

宋小宇, 陈宁, 高凤, 余仲苏. 儿童非嗜肝性病毒感染性肝损害患者病因与转归分析^*[J]. 实用肝脏病杂志, 2025, 28(4): 525-528.

Song Xiaoyu, Chen Ning, Gao Feng, et al. Etiological feature and prognosis of children with non-hepatophilic viral infection with liver injury[J]. Journal of Practical Hepatology, 2025, 28(4): 525-528.

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儿童非嗜肝性病毒感染性肝损害患者病因与转归分析^*

Etiological feature and prognosis of children with non-hepatophilic viral infection with liver injury

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