幼年类风湿性关节炎与人细小病毒B19感染的关系及其临床特征  

Relationship between human parvovirus B19 infection and juvenile rheumatoid arthritis and its clinical forms

作　　者：成胜权[1] 张国成[1] 许东亮[1] 

机构地区：[1]第四军医大学西京医院儿科,西安710032

出　　处：《中华儿科杂志》2000年第8期477-479,共3页Chinese Journal of Pediatrics

摘　　要：目的　探讨幼年类风湿性关节炎 (JRA)与人细小病毒B19(B19)感染的关系及其临床特征。方法　采用巢式PCR方法对 30例JRA患儿血清、2 6例JRA患儿骨髓、4例JRA患儿关节液标本进行B19 DNA检测。结果　 ( 1) 30例JRA患儿血清B19 DNA阳性 12例 ( 40 % ) ,2 5例对照组中阳性 1例 ( 4% ) ,两组差异有非常显著性 (P <0 .0 1)。 ( 2 ) 2 6例骨髓B19 DNA阳性 12例 ( 46 % ) ,10例对照组阳性 1例 ( 1/ 10 ) ,两组差异无显著性 (P >0 .0 5 )。 ( 3) 8例血清和骨髓配对标本中B19 DNA同时阳性 2例 ( 2 / 8) ,只骨髓阳性 2例 ( 2 / 8) ,只血清阳性 1例 ( 1/ 8)。 ( 4) 4例血清和关节液配对标本中B19 DNA同时阳性 2例 ( 2 / 4) ,只关节液阳性 1例 ( 1/ 4)。 ( 5 ) 12例血清B19 DNA阳性患儿中 ,全身型、多关节炎型、少关节炎型各 4例 ,阳性率分别为 4/ 9、4/ 11、4/ 10。 12例骨髓B19 DNA阳性患儿中 ,各型阳性率分别为 5 6 % ( 9/ 16 )、2 / 5、1/ 5。结论　 ( 1)我国JRA人群有较高B19病毒感染率。 ( 2 )JRA与B19病毒感染有较密切关系。 ( 3)B19相关性JRA以全身型及多关节炎型常见。Objective It was reported since 1985 that human parvovirus B19 (HPV B19) was associated with human joint disorders. However we have not seen such reports in Chinese journals. The present study aimed at investigating possible relationship between HPV B19 infection and juvenile rheumatoid arthritis (JRA) and its different clinical types in children. Methods The DNA of HPV B19 was determined by using nested PCR in serum specimens of 30 children with JRA (group 1),15 healthy blood donors and 10 normal children (control group),in bone marrow specimens of 26 children with JRA (group 2),and in joint fluid specimens of 4 children with JRA (group 3). Results (1)Of the 30 cases with JRA in group 1,12 (40%) were positive for HPV B19 DNA,in contrast,only one (4%) of the control specimens was positive for the DNA (P<0.01). (2)Bone marrow specimens of 12 (46 %)of the 26 cases of group 2 were positive for HPV B19 DNA, while only one of the 10 (1/10) was positive(P>0.05). (3)Of 8 cases whose serum and bone marrow specimens were tested,2 (2/8)had HPV DNA in both serum and bone marrow,while another 2 had the DNA only in bone marrow and one only in serum. (4)Tow out of the 4 JRA cases in group 3 had HPV B19 DNA in both serum and joint fluid specimens,one had the DNA only in the joint fluid.(5)Serum specimens of totally 12 children with JRA were positive for HPV B19 DNA; the clinical form of arthritis was systemic in 4,polyarticular in 4 and oligoarticular in the remaining 4; HPV B19 DNA positive rates for the corresponding clinical forms of JRA were 4/9, 4/11 and 4/10, respectively. Among the 12 children with JRA who had HPV B19 DNA in the bone marrow specimens, the positive rates of the DNA for the above mentioned clinical types were 56% (9/16), 2/5 and 1/5, respectively. Conclusion JRA children in the studied series had a higher rate of HPV B19 infection as compared to the control group. The JRA cases exhibited a close association with HPV B19 infection. HPV B19-infected JRA cases mostly had systemic or polyarticular types

关 键 词：细小病毒B19 幼年型类风湿性关节炎 PCR 

分 类 号：R725.9[医药卫生—儿科]