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·722 · 南 京 医 科 大 学 学 报 2026年5月

表3 不同年龄段患者PSM后疗效分析
Table 3 Analysis of therapeutic effects in patients of different age groups after PSM （d，x ± s）
<3 years 4-6 years
Observd index Antiviral General Antiviral General
t P t P
（n=46） treatment（n=46） （n=58） treatment（n=58）
Time of hospitalization 08.16 ± 0.33 07.47 ± 0.35 1.320 0.161 08.74 ± 0.609 08.98 ± 2.13 2.867 0.609
Time of defervescence 06.42 ± 0.66 05.22 ± 0.46 1.520 0.133 06.33 ± 0.62 04.27 ± 0.43 2.747 0.007
Disappearance of pharyngitis 07.35 ± 0.51 05.89 ± 0.53 1.985 0.049 07.41 ± 0.54 05.09 ± 0.45 3.328 0.001
Recovery of hepatomegaly 18.68 ± 1.96 17.06 ± 1.89 0.593 0.555 25.23 ± 1.91 23.71 ± 1.64 0.608 0.545
Recovery of splenomegaly 21.06 ± 2.34 21.71 ± 2.43 -0.191 0.848 27.62 ± 2.25 25.17 ± 1.84 0.843 0.402
Recovery of WBC 13.22 ± 0.84 11.06 ± 0.63 2.101 0.043 13.08 ± 0.65 12.19 ± 0.69 0.933 0.353
Recovery of AL 14.52 ± 0.75 13.17 ± 0.64 1.378 0.173 15.08 ± 0.78 13.66 ± 0.78 1.282 0.204
Recovery of ALT 09.30 ± 1.38 07.22 ± 1.89 0.856 0.395 07.16 ± 1.39 12.24 ± 1.49 -2.476 0.015
Recovery of EBV⁃DNA 12.97 ± 1.70 15.31 ± 1.14 -8.870 0.001 17.61 ± 1.33 19.70 ± 2.14 -9.266 0.034
+
Recovery of CD4 /CD8 + 31.45 ± 1.18 31.46 ± 1.26 2.753 0.996 35.82 ± 1.02 34.77 ± 1.02 2.659 0.825
7-13 years
Observd index
Antiviral（n=30） General treatment（n=30） t P
Time of hospitalization 09.55 ± 0.44 07.62 ± 0.32 1.232 0.044
Time of defervescence 08.85 ± 1.17 06.32 ± 0.54 2.239 0.029
Disappearance of pharyngitis 07.85 ± 1.04 07.62 ± 0.74 0.179 0.857
Recovery of hepatomegaly 29.15 ± 3.25 24.38 ± 1.94 1.342 0.185
Recovery of splenomegaly 32.10 ± 3.36 30.32 ± 2.63 0.408 0.685
Recovery of WBC 14.10 ± 0.93 12.70 ± 0.77 1.120 0.268
Recovery of AL 16.10 ± 0.98 14.08 ± 0.86 1.470 0.147
Recovery of ALT 15.60 ± 3.32 13.97 ± 1.98 0.449 0.655
Recovery of EBV⁃DNA 18.77 ± 1.23 18.43 ± 1.13 0.003 0.998
+
Recovery of CD4 /CD8 + 36.85 ± 1.98 36.05 ± 1.29 0.126 0.899
（%） 1.0 （%） 1.0 （%） 1.0
A B C
Rate of non⁃recovery of splenomegaly 0.6 Antiviral Rate of non⁃recovery of splenomegaly 0.6 Antiviral Rate of non⁃recovery of splenomegaly 0.6 Antiviral
0.8
0.8
0.8

0.4
0.4
0.4
0.2
0.2
0.2
General treatment
General treatment
General treatment
0
25
10
20
5
25
10
20
15
15
5
15
10
5
20
0
25
Recovery of splenomegaly（d） 30 0 0 Recovery of splenomegaly（d） 30 0 0 Recovery of splenomegaly（d） 30
A：The recovery of splenomegaly in the two groups of infancy and early childhood period；B：The recovery of splenomegaly in the two groups of pre⁃
school period；C：The recovery of splenomegaly in the two groups of school⁃age period.
图1 两组患儿脾肿大恢复情况
Figure 1 The recovery of splenomegaly in the two groups
而抑制病毒复制 ［10-11］ 。然而 EBV 相关 IM 的发病机 咽峡炎、肝脾肿大及多项实验室指标方面均明显重
制并非单纯由病毒复制水平决定，而主要由机体针 于对照组，提示临床医师更倾向于对病情较重患儿
对EBV 感染B淋巴细胞的免疫反应所驱动，这也是 实施抗病毒治疗。经PSM校正后，两组基线特征达
抗病毒治疗疗效存在争议的核心原因。 到平衡，能够更真实地反映抗病毒治疗的独立疗
在 PSM 前，本研究发现抗病毒组患儿在发热、 效。结果显示，阿昔洛韦治疗并未缩短住院时间，