EBV合并CMV感染的传染性单核细胞增多症患者T细胞免疫状态及炎症指标变化  

T cell immune status and inflammatory indicator changes in infectious mononucleosis patients complicated with EBV and CMV infections

作　　者：高荣理 陈垂婉[2] 蔡翠珠[3] 黎世贵 陈兴壮[1] GAO Rong-li;CHEN Chui-wan;CAI Cui-zhu;LI Shi-gui;CHEN Xing-zhuang(Sanya Hospital of Traditional Chinese Medicine,Sanya,Hainan 572000,China;不详)

机构地区：[1]三亚市中医院检验科,海南三亚572000 [2]三亚市妇幼保健院检验科,海南三亚572000 [3]三亚市中医院内五科,海南三亚572000

出　　处：《中华医院感染学杂志》2020年第19期2975-2978,共4页Chinese Journal of Nosocomiology

基　　金：海南省卫生厅科学研究基金资助项目(琼卫2017-PT-13)。

摘　　要：目的探讨EB病毒(Epstein-barr virus,EBV)合并巨细胞病毒(Cytomegalovirus,CMV)感染的传染性单核细胞增多症(Infectious mononucleosis,IM)中患者免疫状态及炎症指标的改变。方法选择三亚市中医院2017年6月-2019年6月确诊为EB病毒感染致传染性单核细胞增多症合并CMV感染患者40例作为研究对象纳入试验组,另随机选择80例由EB病毒单纯感染引起传染性单核细胞增多症患者作为对照组。收集患者性别、年龄、发热时间、住院时间、临床症状等。测定两组患者的血清免疫球蛋白G(Immunoglobulin G,IgG)、IgA、IgM水平,外周血T淋巴细胞亚群,全身炎性指标白细胞计数(White blood cell count,WBC)、C-反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT),肝功能指标丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转氨酶(Aspartate aminotransferase,AST)、谷氨酰转肽酶(Glutamyltranspeptidase,GGT)、总胆红素(Total bilirubin,TBIL)、碱性磷酸酶(Alkaline phosphatase,ALP)、乳酸脱氢酶(Lactate dehydrogenase,LDH)。结果试验组年龄、住院时间分别为(33.24±4.37)岁、(15.26±2.82)d高(长)于对照组(P<0.001);试验组IgG、IgA、IgM分别为(13.29±3.88)g/L、(1.89±0.62)g/L、(1.62±0.54)g/L均高于对照组(P<0.05);试验组CD4+T淋巴细胞、CD4+/CD8+、自然杀伤(Nature kill,NK)细胞分别为(16.39±3.18)%、(0.69±0.21)、(0.26±0.14)×105/L低于对照组,CD8+T淋巴细胞为(33.24±6.85)%高于对照组(P<0.05),试验组全身炎性指标WBC、CRP和PCT分别为(16.87±3.62)×109/L、(1.87±0.32)mg/dl、(0.32±0.06)μg/L高于对照组(P<0.001);试验组AST、ALT、TBIL、ALP分别为(76.52±21.38)U/L、(63.88±18.23)U/L、(23.28±6.12)μmol/L、(223.87±62.35)U/L高于对照组(P<0.001)。结论合并CMV感染的IM患者临床症状更为严重,免疫状态及炎性指标改变更为明显,应加强临床观察,避免肝损害的发生。OBJECTIVE To investigate the changes of immune status and inflammation indexes in patients with infectious mononucleosis infected by Epstein-Barr virus(EBV)and Cytomegalovirus(CMV)simultaneously.METHODS Totally 40 patients with infectious mononucleosis caused by Epstein-Barr virus infection and CMV infection in Sanya City Hospital of Traditional Chinese Medicine from Jun.2017 to Jun.2019 were included in the experimental group as research subjects,and another 80 patients with infectious mononucleosis caused by Epstein-Barr virus infection alone were randomly selected as the control group.The patient’s gender,age,fever time,hospitalization time,clinical symptoms,etc.were collected.The serum immunoglobulin G(IgG),IgA,IgM levels,peripheral blood T lymphocyte subsets,white blood cell count(WBC),C-reactive protein(C reactive protein(CRP),procalcitonin(PCT),liver function indicators alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transfer peptidase(Glutamyltranspeptidase,GGT),total bilirubin(TBIL),alkaline phosphatase(ALP),lactate dehydrogenase(LDH)in the two groups were measured.RESULTS The age and length of hospital stay in the experimental group were(33.24±4.37)years old and(15.26±2.82)days,respectively.higher(longer)than those in the control group(P<0.001).The IgG,IgA,and IgM of the experimental group were(13.29±3.88)g/L,(1.89±0.62)g,and(1.62±0.54)g/L,respectively,all significently higher than those of the control group(P<0.05).The CD4+T lymphocytes,CD4+/CD8+,and natural killer(NK)cells in the experimental group were(16.39±3.18)%,(0.69±0.21),(0.26±0.14)×105/L respectively,lower than those of the control group.The CD8+T lymphocytes were(33.24±6.85)%,significently higher than that of the control group(P<0.05).The systemic inflammatory indexes WBC,CRP and PCT of the experimental group were(16.87±3.62)×109,(1.87±0.32)mg/dl,and(0.32±0.06)μg/L,respectively,significently higher than that of the control group(P<0.001).The AST,ALT,TBIL,ALP in the experimental group are(76.52±21.38)U/

关 键 词：传染性单核细胞增多症 巨细胞病毒 EB病毒 

分 类 号：R378[医药卫生—病原生物学]