EB病毒感染患儿CD163表达及其临床意义  

Expression of CD163 in children with Epstein-Barr virus infection

作　　者：陈燕丽[1] 陈福雄[2] 邓长柏[1] 夏波[2] 吴丽萍[2] 吴泽霖[2] 卢慧敏[2] 

机构地区：[1]广州医科大学附属第五医院儿科,广东广州510700 [2]广州医科大学附属第一医院儿科,广东广州510120

出　　处：《中国当代儿科杂志》2015年第5期492-495,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的通过检测EB病毒(EBV)感染患儿CD163水平,探讨CD163在EBV相关噬血细胞综合征(HLH)的诊断、病情监测及预后中的意义。方法将因不同感染就诊的94例患儿分为EBV阳性组(n=55)和EBV阴性组(n=39,对照组),进一步将EBV阳性患儿分为传染性单核细胞增多症(IM)组(n=47)和HLH组(n=8)。应用酶联免疫法检测血清可溶性CD63(s CD163)水平;流式细胞术检测外周血单核细胞表面CD163表达率。结果 HLH患儿血清s CD163水平均>10000ng/m L,其中3例>30000ng/m L;HLH组患儿血清s CD163水平远高于对照组和IM组(P<0.05)。EBV阳性患儿血清s CD163水平与EBV-DNA拷贝数、乳酸脱氢酶和血清铁蛋白水平呈正相关,与白细胞计数、中性粒细胞计数、血红蛋白和血小板计数呈负相关(P<0.05)。HLH患儿s CD163水平在治疗后逐步下降,但随病情反复又升高。结论 EBV感染患儿的CD163水平与临床严重程度密切相关,s CD163>10000ng/m L的EBV感染患儿需警惕并发HLH。ObjectiveTo study the clinical signiifcance of CD163 in the diagnosis and the evaluation of severity and prognosis of childhood hemophagocytic lymphohistiocytosis （HLH）.MethodsNinety-four children were classiifeied into Epstein-Barr virus （EBV）-positive （n=55） and EBV-negative groups （n=39; control group）. The EBV-positive group was subgrouped into infectious mononucleosis （IM;n=47） and HLH （n=8）. Serum levels of soluble CD163 were measured using ELISA. Expression of CD163 on mononuclear cells was detected by flow cytometry. ResultsThe serum levels of soluble CD163 were 〉 10 000 ng/mL in all eight HLH patients （〉 30 000 ng/mL in 3 cases）. The mean serum levels of soluble CD163 in the HLH group were signiifcantly higher than in the control and IM groups （P〈0.05）. The serum levels of soluble CD163 in EBV-positive children were positively correlated with EBV-DNA copies and serum levels of ferritin and LDH, but were negatively correlated with white blood cell count, neutrophil count, hemoglobin and platelet count. The follow-up after treatment for three HLH patients showed that serum levels of soluble CD163 were signiifcantly reduced, but the soluble CD163 levels rebounded in one patient who was complicated by fungal pneumonia infection.ConclusionsThe levels of serum soluble CD163 may be related to the severity in children with HLH. The EBV-positive children with soluble CD163 levels 〉10 000 ng/mL should be considered the possibility of HLH.

关 键 词：EB病毒 噬血细胞综合征 CD163 儿童 

分 类 号：R725.1[医药卫生—儿科]