EB病毒核酸和血清学检测在儿童传染性单核细胞增多症中的应用  

Application of Epstein-Barr Virus Nucleic Acid and Serology Tests in Children with Infectious Mononucleosis

作　　者：刘丽莎[1] 张峰 殷丝雨[1] LIU Lisha;ZHANG Feng;YIN Siyu(Department of Clinical Laboratory,Children’s Hospital of Nanjing Medical University,Nanjing Jiangsu21008,China)

机构地区：[1]南京医科大学附属儿童医院检验科,江苏南京210008 [2]皖南医学院医学检验系

出　　处：《华南国防医学杂志》2021年第3期185-187,共3页Military Medical Journal of South China

摘　　要：目的通过对传染性单核细胞增多症(infectious mononucleosis, IM)患儿血标本进行EB病毒(Epstein-Barr virus, EBV)核酸及EBV血清学检测,评估二者之间的相关性及在疾病诊断学中的应用价值。方法回顾性分析2020-05/2020-09月在南京医科大学附属儿童医院住院确诊为传染性单核细胞增多症的85例患儿病例资料,同时选择40例同年龄段择期手术患儿作为对照。实时荧光定量聚合酶链反应(real-time quantitative polymerase chain reaction, qPCR)法检测外周血中EBV核酸载量,并采用化学发光法检测外周血清中EBV抗体。观察两组患儿EBV核酸载量、衣壳抗原IgM(VCA IgM)、衣壳抗原IgG(VCA IgG)、早期抗原IgM(EA IgM)和核心抗原IgG(NA IgG)、衣壳抗原IgA(VCA IgA)和核心抗原IgA(NA IgA)的表达情况。结果 EBV DNA在两组间的阳性率分别为75.6%(62/85)及7.5%(3/40)。VCA IgM在两组间的阳性率分别为92.9%(79/85)及5%(2/40),VCA IgG在两组间的阳性率分别为37.6%(32/85)及15%(6/40),EA IgM在两组间的阳性率分别为21.2%(18/85)及2.5%(1/40),NA IgG在两组间的阳性率分别为27.1%(23/85)及20%(8/40),VCA IgA在两组间的阳性率分别为15.3%(13/85)及0%(0/40),NA IgA在两组间的阳性率分别为4.7%(4/85)及0%(0/40)。结论传染性单核细胞增多症感染患儿外周血中可检出EBV DNA和特异性抗体,以VCA IgM和EA IgM多见。此外,同一患儿EBV核酸和病毒血清学检测结果不吻合时,临床应该联合检测抗原抗体避免疾病漏诊误诊。Objective To investigate the correlation of Epstein-Barr virus(EBV) DNA and EBV serology markers in children with infectious mononucleosis(IM), and evaluate the clinical application values.Methods Peripheral blood sample from 85 children diagnosed IM and 40 childen undergoing elective surgery from May 2020 to September 2020 in Nanjing children’s hospital were collected.Real-time quantitative polymerase chain reaction(qPCR) was performed to detect the levels of EBV-DNA in plasma. Chemiluminescent immunoassay was performed to detect the VCA IgM,VCA IgG,EA IgM,NA IgG,VCA IgA and NA IgA in serum.Results The positive rates of EBV-DNA between the two groups were 75.6%(62/85) and 7.5%(3/40), respectively. The positive rate of VCA IgM of the two groups were 92.9%(79/85) and 5%(2/40),the positive rate of VCA IgG were 37.6%(32/85) and 15%(6/40), the positive rate of EA IgM were 21.2%(18/85) and 2.5%(1/40), the positive rate of NA IgG were 27.1%(23/85) and 20%(8/40), the positive rate of VCA IgA were 15.3%(13/85) and 0%(0/40), and the positive rate of NA IgA were 4.7%(4/85) and 0%(0/40).Conclusion EBV DNA and EBV serology marker can be detected in the peripheral blood of children with IM,VCA IgM and EA IgM are more common.When the results of EBV nucleic acid and serology in the same child are inconsistent, the antigens and antibodies detection should be combined to avoid missed diagnosis and misdiagnosis.

关 键 词：EB病毒 传染性单核细胞增多症 血清学检查 抗体 抗原 儿童 

分 类 号：R725.1[医药卫生—儿科]