反应性淋巴细胞、白细胞分类及EB病毒与儿童传染性单核细胞增多症的关系  

Relations of atypical lymphocytes,white blood cell classification and EB virus with infectious mononucleosis in children

作　　者：黄琳淋[1] 幸娟霞 邓文平[1] HUANG Linlin;XING Juanxia;DENG Wenping(Department of Clinical Laboratory,Fuling Center Hospital of Chongqing City,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院医学检验科,重庆408000

出　　处：《检验医学》2018年第8期727-729,共3页Laboratory Medicine

摘　　要：目的探讨儿童传染性单核细胞增多症反应性淋巴细胞增高(>10%)与EB病毒衣壳蛋白Ig M(EBVCA-Ig M)抗体阳性率、白细胞(WBC)分类的关系,为临床诊断传染性单核细胞增多症提供实验室依据。方法采用双盲法分别镜检,判断反应性淋巴细胞。选取反应性淋巴细胞增高(>10%)的患儿80例,采用酶联免疫吸附试验(ELISA)检测EBV-CA-Ig M抗体,采用XE-2100全自动血液分析仪进行WBC分类。采用受试者工作特征(ROC)曲线评价各项指标诊断传染性单核细胞增多症的效能。结果反应性淋巴细胞>10%的患儿中传染性单核细胞增多症占81.3%、细菌感染占18.7%;反应性淋巴细胞>20%的患儿中传染性单核细胞增多症占100.0%。传染性单核细胞增多症患儿淋巴细胞百分比[(65.76±12.39)%]明显高于细菌感染患儿[(41.57±18.79)%](P<0.05)。EBV-CA-Ig M抗体、反应性淋巴细胞、WBC总数、淋巴细胞百分比及单核细胞百分比诊断传染性单核细胞增多症的曲线下面积(AUC)分别为0.854、0.688、0.658、0.848、0.482。结论 EB病毒是引起传染性单核细胞增多症的病因,但部分患儿可出现EBV-CA-Ig M抗体阴性。传染性单核细胞增多症患儿淋巴细胞百分比明显增高。反应性淋巴细胞增高(>20%)可用于筛查儿童传染性单核细胞增多症。Objective To investigate the relations of atypical lymphocytes 〉10%,white blood cell（WBC） classification and EB virus capsid protein IgM（EBV-CA-IgM）antibody with infectious mononucleosis in children.Methods A total of 80 patients with atypical lymphocytes 〉10% were enrolled by double-blind method. Enzyme-linked immunosorbent assay（ELISA）was used to determine EBV-CA-IgM antibody,and XE-2100 automatic hematology analyzer was used for WBC classification. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency of these parameters for the diagnosis of infectious mononucleosis.Results Infectious mononucleosis accounted for 81.3% in patients with atypical lymphocytes 〉10%,bacterial infection accounted for 18.7%. Infectious mononucleosis accounted for 100.0% in patients with atypical lymphocytes 〉20%. The percentage of lymphocytes was （65.76±12.39）% in patients with infectious mononucleosis,and the percentage of lymphocytes was （41.57±18.79）% in patients with bacterial infection（P〈0.05）. The areas under ROC curves（AUC） of EBV-CA-IgM antibody,atypical lymphocyte,WBC count,lymphocyte percentage and the percentage of mononuclear cell for the diagnosis of infectious mononucleosis were 0.854,0.688,0.658,0.848 and 0.482.Conclusions EB virus causes infectious mononucleosis,but some patients show negative for EBV-CA-IgM antibody. However,the percentage of lymphocyte in infectious mononucleosis increases,and atypical lymphocyte 20% can be used as a parameter for screening infectious mononucleosis.

关 键 词：反应性淋巴细胞 白细胞分类 EB病毒衣壳蛋白IgM抗体 传染性单核细胞增多症 

分 类 号：R446.1[医药卫生—诊断学]