目的 總結兒童傳染性單核細胞增多癥(IM)合并肝損害的臨床特點及相關因素。 方法 對2000年1月－2012年1月入院收治48例合并肝損害IM與120例無肝損害IM的患兒年齡、性別、主要癥狀和體征、系統損害、實驗室檢查等資料進行回顧性分析。 結果 合并肝損害IM患兒血小板減少、異形淋巴細胞增加、丙氨酸氨基轉換酶和天門冬氨酸氨基轉移酶等血清酶學異常、持續發熱、中重度肝脾腫大，以及多系統損害發生率較高；而咽峽炎、皮疹和淺表淋巴結腫大發生率較低；IM合并肝損害與發病年齡、性別無明顯相關（r=0.127，0.075，P＜0.05）。 結論 IM合并肝損害表現為持續發熱、肝脾腫大、肝酶異常、血小板減少、異形淋巴細胞增加較常見。及時作肝功能等輔助檢查，及早發現和干預IM肝損害，有助于減少重癥IM的發生。
Objective To assess the clinical efficacy of ultrasonic atomization of penicillin combined with erythromycin in children with acute suppurative tonsillitis. Methods From July 2007 to December 2007, 70 children with a confirmed diagnosis of acute suppurative tonsillitis were randomized into two groups. Thirty-one patients in the control group received continuous 5-day treatment of routine intravenous drip of penicillin (200000units/ (kg?d)), twice a day, while 39patients in the trial group received, in addition to the routine treatment, another 5-day treatment of ultrasonic atomization of 0.1 g erythromycin and 10ml saline diluted by 10ml sterile water, 15min for each treatment, twice a day. Observation of the clinical efficacy of the two groups and statistical analyses were conducted. Results The cure rate and total effective rate of the trial group were 61.54% and 97.44%, and those of the control group were 35.48% and 77.42%, respectively. The pyretolysis rates at 48 h and 72 h in the trial group were 75.36% and 89.74%, and those in the control group were 45.16% and 61.29%, respectively. The improvement rates of pharyngodynia at 48 h and 72 h in the trial group were 76.92% and 92.31%, and those in the control group were 48.39% and 70.97%, respectively. The results of both rank sum test and chi-square test revealed significant differences between the trial group and the control groups (Plt;0.05), which indicated that the trial group was superior to the control group in terms of cure rate, total effectiveness rate, pyretolysis rate and improvement of pharyngodynia. During ultrasonic atomization, 3 patients experienced mild nausea and vomiting, all of which disappeared after rest. No other adverse reactions were recorded. Conclusions Ultrasonic atomization of penicillin combined with erythromycin for children with acute suppurative tonsillitis is worthy of clinical application due to its better efficacy and safety profile.