PCR和血清学检测在儿童EB病毒感染诊断中的意义  

Significance of PCR and serologic test in diagnosis of Epstein-Barr virus infection in children

作　　者：牟文凤[1] 杨丽[1] 于华 徐莉莉[1] 王亚秋[1] 

机构地区：[1]青岛市妇女儿童医院青岛大学附属青岛妇女儿童医院检验科,山东青岛266034 [2]青岛市市北区镇江路街道社区卫生服务中心,山东青岛266024

出　　处：《中华医院感染学杂志》2017年第1期208-211,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨PCR与血清学检测在儿童EB病毒(EBV)感染性疾病诊断中的意义。方法选取2015年1月-2016年1月疑似EB病毒感染的住院患儿245例,根据年龄分为婴儿组、幼儿组、学龄前组和学龄组,采用化学发光免疫分析法进行血清VCA IgM、EA IgG及NA IgG的检测,同时采用实时荧光定量PCR法检测全血和血浆中EBV-DNA载量,并根据检测结果将患儿分为原发感染组、再激活组和既往感染组,比较不同年龄和不同感染组间EBV血清学和PCR法检测阳性率的差异。结果血浆EBV-DNA阳性率和拷贝数均明显低于全血(P=0.00);在原发感染组和再激活组,全血DNA阳性率均高于血浆DNA和血清学阳性率(P=0.00);按年龄组分类,血清学阳性率在婴儿组低于其他年龄组(χ2=12.38,P=0.00);在婴儿组、幼儿组和学龄前组,全血DNA阳性率均高于血清学(P<0.05),在学龄组,两者差异无统计学意义。结论 PCR与血清学检测EBV感染的阳性率和意义不同,应尽量采用两种方法结合来检测儿童EBV感染。OBJECTIVE To explore the significance of PCR and serologic test in diagnosis of Epstein-Barr （EB） vi- rus infection in children. METHODS A total of 245 children with suspected EB virus infection who were hospital- ized from Jan 2015 to Jan 2016 were enrolled in the study and divided into the infant group, the early childhood group, the preschool group, and the school age group according to the age of the children. The serum VCA IgM, EA IgG, and NA IgG were detected by means of chemiluminescence immune assay, meanwhile, the EBV-DNA loads in whole blood and plasma were determined by using real-time fluorescence quantification PCR method, the children were divided into the primary infection group, the reactivation group, and the previous infection group ac- cording to the test results. The positive rates of serologic and PCR detection of EBV were observed and compared among the different age groups and the different infection groups. RESULTS The positive rate and copy number of EBV-DNA were significantly lower in the plasma than in the whole blood （P= 0. 00）. In the primary infection group and the reactivation group, the positive rate of whole blood DNA was higher than that of the plasma DNA and the serology （P= 0.00）. The positive rate of serologic test was lower in the infant group than in other age groups （X^2=12.38,P= 0.00）. The positive rate of whole blood DNA was higher than that of the serologic test in the infant group, the early childhood group, and the preschool group （P^0.05） ; there was no significant differ- ence between the positive rate of whole blood DNA and the positive rate of the serologic test in the school age group. CONCLUSION The serologic test and PCR vary in the positive rate of EB virus infection and the signifi- cance, and it is necessary to try to take the combination of the two methods to detect the EBV infection in children.

关 键 词：EB病毒 血清学 实时荧光定量PCR 儿童 

分 类 号：R446[医药卫生—诊断学]