儿童EB病毒感染的流行病学调查及血清学特征分析  

Epidemiological survey and serological characteristic analysis of Epstein-Barr virus infection in the children

作　　者：王博[1] 齐莹[1] 阮强[1] Wang Bo;Qi Ying;Ruan Qiang(Virology Laboratory,Shengjing Hospital,China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院病毒研究室,沈阳110004

出　　处：《中华实用儿科临床杂志》2020年第18期1403-1406,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81672028)。

摘　　要：目的了解沈阳地区儿童EB病毒(EBV)感染的流行情况,分析其血清学特征。方法采用LIAISON化学发光分析仪检测2017年8月至2018年7月于中国医科大学附属盛京医院就诊的26714例患儿血清中抗EBV衣壳抗原IgM(VCA-IgM)抗体、抗衣壳抗原IgG(VCA-IgG)抗体、抗核抗原IgG(EBNA-IgG)抗体及抗早期抗原IgG(EA-IgG)抗体。根据VCA-IgM、VCA-IgG及EBNA-IgG 3项主要抗体的检测结果判断EBV感染状态;对其中VCA-IgM单独阳性的患儿,4~6周后复查EBV抗体。结果26714例患儿中VCA-IgM抗体阳性2963例(11.09%),VCA-IgG抗体阳性15349例(57.46%),EBNA-IgG抗体阳性14263例(53.39%)及EA-IgG抗体阳性731例(2.74%)。15149例男童VCA-IgM、VCA-IgG、EBNA-IgG及EA-IgG抗体阳性率分别为10.98%(1663/15149例)、57.73%(8745/15149例)、53.49%(8103/15149例)及2.57%(389/15149例),11565例女童上述抗体阳性率分别为11.24%(1300/11565例)、57.10%(6604/11565例)、53.26%(6160/11565例)及2.96%(342/11565例),不同性别患儿在4项抗体检测阳性率间的差异均无统计学意义(均P>0.05);VCA-IgG及EGNA-IgG抗体阳性率随患儿年龄的增长逐步增高(χ2=4057.744、4776.285,均P<0.05),至14岁时,患儿VCA-IgG及EBNA-IgG的阳性率分别达到87.98%(1317/1497例)及88.78%(1329/1497例);三抗体联合检测显示,在VCA-IgM阳性的急性感染患儿中,以典型原发感染状态[36.38%(1078/2963例)]及原发感染恢复期或再激活状态[43.81%(1298/2963例)]为主;而VCA-IgG及EBNA-IgG双阳性的抗体组合模式占既往感染患儿的95.09%(12777/13437例)。在198例VCA-IgM单独阳性患儿中,有133例(67.17%)在复查时未发生血清IgG阳转。在所有就诊患儿中,无单独EA-IgG阳性患儿,而既往感染的患儿中3.19%(428/13437例)EA-IgG阳性。结论EBV 4项抗体阳性率在男女患儿中无差异,其既往感染率随年龄增长而升高;抗体联合检测可为临床诊断提供更详细和可靠的信息;双份血清抗体检测可提高诊断的准确率;而EA-IgG是诊断EBV既往�Objective To investigate the epidemic situation of Epstein-Barr virus (EBV) infection in children in Shenyang and analyze the serological characteristics.Methods The IgM antibody against EBV capsid antigen (VCA-IgM), IgG antibodies against capsid antigen (VCA-IgG), nuclear antigen IgG (EBNA-IgG) and early antigen (EA-IgG) of 26 714 pediatric patients hospitalized in Shengjing Hospital, China Medical University from August 2017 to July 2018 were detected simultaneously by LIAISON chemiluminescence analyzer.The infection stages of EBV were determined comprehensively according to the antibody spectrum of VCA-IgM, VCA-IgG and EBNA-IgG.Meanwhile, EBV antibodies were re-examined after 4-6 weeks in the patients with positive VCA-IgM only.Results Among the 26 714 patients, a total of 2 963 cases (11.09%) were VCA-IgM positive, 15 349 cases (57.46%) were VCA-IgG positive, 14 263 cases (53.39%) were EBNA-IgG positive and 731 cases (2.74%) were EA-IgG positive.The positive rates of VCA-IgM, VCA-IgG, EBNA-IgG and EA-IgG in 15 149 boys were 10.98% (1 663/15 149 cases), 57.73% (8 745/15 149 cases), 53.49% (8 103/15 149 cases) and 2.57% (389/15 149 cases), respectively.The positive rates of VCA-IgM, VCA-IgG, EBNA-IgG and EA-IgG in 11 565 girls were 11.24% (1 300/11 565 cases), 57.10% (6 604/11 565 cases), 53.26% (6 160/11 565 cases) and 2.96% (342/11 565 cases), respectively.There was no significant difference in the positive rates of the 4 antibodies between male and female(all P>0.05). The positive rates of VCA-IgG and EBNA-IgG increased gradually with the age of children (χ2=4 057.744, 4 776.285, all P<0.05), and those of VCA-IgG and EBNA-IgG were 87.98%(1 317/1 497 cases) and 88.78%(1 329/1 497 cases) respectively when children reached 14 years old.Typical primary infection [36.38%(1 078/2 963 cases)] and the recovery or reactivation of primary infection[43.81%(1 298/2 963 cases)] were predominant in acute infection children with positive VCA-IgM.Moreover, 95.09% (12 777/13 437 cases) of the previously infected cases had b

关 键 词：EB病毒 血清流行病学 抗衣壳抗原 抗早期抗原 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]