EBV-IM患儿外周血EBV-DNA载量与Th1/Th2相关细胞因子及临床特征的关系  

Relationship between peripheral blood EBV-DNA load and Th1/Th2 cell ratio and clinical features in children infected with EBV-IM

作　　者：计晓兰 胡春霞 孔令军 褚培培 缪鑫霞 JI Xiao-lan;HU Chun-xia;KONG Ling-jun;CHU Pei-pei;MIAO Xin-xia(Suzhou Wujiang District Children's Hospital,Suzhou,Jiangsu 215200,China)

机构地区：[1]苏州市吴江区儿童医院儿内科,江苏苏州215200

出　　处：《中华医院感染学杂志》2023年第16期2503-2507,共5页Chinese Journal of Nosocomiology

基　　金：苏州市吴江区“科教兴卫”项目(WWK202025)。

摘　　要：目的 探讨EB病毒(EBV)感染的传染性单核细胞增多症(IM)患儿EBV-DNA载量与外周血辅助型T细胞(Th)1/Th2型相关因子及临床特征的关系。方法 选取2020年1月-2021年7月在吴江区儿童医院确诊为EBV-IM患儿73例作为研究对象。采用荧光定量聚合酶链式反应(qPCR)检测患儿外周血中EBV-DNA。根据病毒拷贝数,将所有患儿分为低载量组(n=17),中载量组(n=35)和高载量组(n=21)。检测三组患儿相关生化指标[白细胞(WBC)、血沉(ESR)、谷丙转氨酶(ALT)、乳酸脱氢酶(LDH)、肌酸肌酶同工酶(CK-MB)]、Th1/Th2型细胞标志物[白细胞介素(IL)-2、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、IL-4、IL-6、IL-10]及淋巴细胞亚群水平[CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、CD_(19)^(+)、CD16^(+)+CD_(56)^(+)];观察三组患儿的临床特征。结果 中、高载量组WBC、ESR、ALT、IL-2、IFN-γ、TNF-α、IL-6水平均高于低载量组,IL-4、IL-10水平均低于低载量组(P<0.05);中、高载量组CD_(3)^(+)、CD_(8)^(+)水平高于低载量组,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、CD_(19)^(+)、CD16^(+)+CD_(56)^(+)水平低于低载量组(P<0.05);高载量组发热时间和住院时间均长于低载量和中载量组(P<0.05);高载量组咽峡炎发生率高于低载量组(P<0.05),肝脾肿大发生率均高于低载量和中载量组(P<0.05)。结论 不同EBV-DNA载量患儿外周血Th1/Th2细胞因子表达水平和临床特征存在差异,且EBV-DNA载量与Th1/Th2细胞因子存在相关性,可以反映疾病的严重程度。OBJECTIVE To explore the relationship between EBV-DNA load and peripheral blood Th1/Th2 cell ratio and clinical features in children with Epstein-Barr virus(EBV)infected infectious mononucleosis(IM).METHODS A total of 73 children confirmed with EBV-IM in Wujiang District Children′s Hospital between Jan 2020 and Jul 2021 were enrolled.EBV-DNA in peripheral blood was detected by fluorescence quantitative polymerase chain reaction(qPCR).According to virus copies,they were divided into the low-load group(n=17),medium-load group(n=35)and high-load group(n=21).The levels of related biochemical indexes including white blood cell(WBC),erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),lactate dehydrogenase(LDH)and creatine enzyme MB(CK-MB),Th1/Th2 markers including interleukin(IL)-2,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),IL-4,IL-6 and IL-10 and lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),CD_(19)^(+),CD_(16)^(+)CD_(56)^(+))in the three groups were detected.The clinical characteristics among the three groups were observed.RESULTS The levels of WBC,ESR,ALT,IL-2,IFN-γ,TNF-αand IL-6 in the medium-load and high-load groups were higher than those in the low-load group,while levels of IL-4 and IL-10 were lower than those in the low-load group(P<0.05).The levels of CD_(3)^(+)and CD_(8)^(+)in the medium-load and high-load groups were higher than those in the low-load group,while levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),CD_(19)^(+)and CD_(16)^(+)CD_(56)^(+)were lower than those in the low-load group(P<0.05).Patients in the high-load group had longer duration of fever and length of hospital stay than those in the low-load and medium-load groups(P0.05).The incidence of angina in the high-load group was higher than that in the low-load group(P<0.05).The incidence of hepatosplenomegaly in the high-load group was higher than that in the low-load group and the medium-load group(P<0.05).CONCLUSION There are differences in Th1/Th2 cell ratio and clinical characteristics in

关 键 词：EB病毒感染 儿童传染性单核细胞增多症 Th1/Th2型细胞标志物 EBV-DNA载量 相关性 

分 类 号：R725.1[医药卫生—儿科]