临床疑似EBV感染成年病人EBV特异性抗体检测  

SIGNIFICANCE OF EPSTEIN-BARR VIRUS SPECIFIC ANTIBODY DETECTION IN ADULT PATIENTS WITH SUSPECTED EPSTEIN-BARR VIRUS INFECTION

作　　者：于洋[1] 吴国才[1] 刘霞[2] 江冰[1] 周娜[3] 李慧[1] YU Yang;WU Guocai;LIU Xia;JIANG Bing;ZHOU Na;LI Hui(Department of Laboratory,The Affiliated Hospital of Qingdao University,Qingdao 266555,China;不详)

机构地区：[1]青岛大学附属医院检验科,山东青岛266555 [2]青岛大学附属医院生殖医学科,山东青岛266555 [3]青岛大学附属医院小儿外科,山东青岛266555

出　　处：《青岛大学学报（医学版）》2019年第6期730-733,736,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省优秀中青年科学家科研奖励基金项目(BS2014YY052);黄岛区科技项目(2014-1-76)

摘　　要：目的探讨EB病毒(EBV)特异性抗体检测在临床疑似EBV感染成年病人诊断中的意义。方法2015年12月—2016年11月,收集我院黄岛院区631例临床疑似EBV感染成年病人的血清,采用化学发光法检测每份血清6种EBV特异性抗体水平,对检测结果进行分析。结果631例血清标本中,EBV-EA IgA、EBV-EA IgG、EBV-NA IgG、EBV-VCA IgA、EBV-VCA IgG、EBV-VCA IgM阳性率分别为6.8%、10.8%、94.3%、7.3%、75.1%、8.4%。6种抗体检测结果均为阴性的未感染者占1.4%。EBV-VCA IgG阳性率秋季显著高于其他季节(χ^2=75.22,q=10.065~14.417,P<0.05);EBV-VCA IgG阳性率有随年龄增长逐渐升高的趋势,不同年龄组间差异有统计学意义(χ^2=9.20,q=2.969、3.611,P<0.05)。EBV-NA IgG阳性率在30~49岁年龄组最高,差异有统计学意义(χ^2=10.17,q=4.143、3.598,P<0.05)。EBV-EA IgA阳性率秋季最高(χ^2=9.06,q=3.681,P<0.05),70~90岁年龄组高于其他年龄组(χ^2=14.78,q=2.835~4.754,P<0.05)。EBV-VCA IgM阳性的急性EBV感染成年病人中以不明原因发热、自身免疫性疾病、慢性肾功能不全及尿毒症、淋巴瘤就诊者分别占28.3%、22.6%、18.9%、11.3%和9.4%。结论临床疑似EBV感染成年病人EBV特异性抗体阳性率高,且6种抗体阳性率有各自特点;急性EBV感染相关疾病以不明原因发热、自身免疫性疾病、慢性肾功能不全及尿毒症、淋巴瘤等为主,对这些疾病病人进行EBV抗体检测有助于尽早明确病因、指导临床诊疗工作。Objective To investigate the significance of Epstein-Barr virus(EBV)-specific antibody detection in the diagnosis of adult patients with suspected EBV infection.Methods From December 2015 to November 2016,serum samples were collected from 631 adult patients with suspected EBV infection who were treated in Huangdao Branch of our hospital.Chemiluminescence immunoassay was used to measure the levels of six EBV-specific antibodies,and the results were analyzed.Results Among the 631 serum samples,the positive rates of EBV-EA IgA,EBV-EA IgG,EBV-NA IgG,EBV-VCA IgA,EBV-VCA IgG,and EBV-VCA IgM were 6.8%,10.8%,94.3%,7.3%,75.1%,and 8.4%,respectively,and 1.4% of the samples were ne-gative for all antibody tests.The positive rate of EBV-VCA IgG in autumn was significantly higher than that in the other seasons(χ^2=75.22,q=10.065-14.417,P<0.05),and the positive rate of EBV-VCA IgG tended to increase with age,with a significant difference between age groups(χ^2=9.20;q=2.969,3.611;P<0.05).The highest positive rate of EBV-NA IgG was observed in the age group of 30-49 years(χ^2=10.17;q=4.143,3.598;P<0.05).The highest positive rate of EBV-EA IgA was observed in autumn(χ^2=9.06,q=3.681,P<0.05),and the age group of 70-90 years had a significantly higher positive rate than the other age groups(χ^2=14.78,q=2.835-4.754,P<0.05).Among the adult patients with acute EBV infection and positive EBV-VCA IgM,those who attended the hospital due to unexplained pyrexia accounted for the highest proportion of 28.3%,followed by the patients who attended the hospital due to autoimmune diseases(22.6%),chronic renal insufficiency(18.9%),uremia(11.3%),or lymphoma(9.4%).Conclusion There are high positive rates of EBV-specific antibodies in adult patients with suspected EBV infection,and the positive rates of the 6 EBV-specific antibodies have their own characteristics.The diseases associated with acute EBV infection mainly include unexplained pyrexia,autoimmune diseases,chronic renal insufficiency,uremia,and lymphoma.EBV-specific antibody detection i

关 键 词：疱疹病毒4型 人 抗体 成年人 

分 类 号：R373.9[医药卫生—病原生物学] R446.62[医药卫生—基础医学]