血β2-微球蛋白、腺苷脱氨酶在儿童传染性单核细胞增多症中的变化及意义  

Changes and significance of bloodβ2-microglobulin and adenosine deaminase in infectious mononucleosis

作　　者：姜荣 王继帆 郑雪辉 JIANG Rong;WANG Ji-fan;ZHENG Xue-hui(Quzhou Hospital of Zhejiang Chinese Medicine University(Quzhou People’s Hospital),Quzhou,Zhejiang 324000,China)

机构地区：[1]浙江中医药大学附属衢州医院(衢州市人民医院),浙江衢州324000

出　　处：《中国卫生检验杂志》2023年第19期2357-2360,2365,共5页Chinese Journal of Health Laboratory Technology

基　　金：2021年度衢州市指导性科技攻关项目(2021036)。

摘　　要：目的 探讨血β2-微球蛋白(β2-MG)、腺苷脱氨酶(ADA)在儿童传染性单核细胞增多症(IM)中的变化及意义。方法 回顾性分析2021年1月—2022年12月本院收治的86例IM患儿的临床资料,选取同时期收治的77例呼吸道疾病患儿作为非IM组,比较2组患儿一般资料和实验室指标,采用logistic回归分析实验室指标与IM之间的关系,分析实验室指标诊断IM的价值;对比不同疾病时期IM患儿的β2-MG、ADA水平,采用Pearson相关性分析β2-MG、ADA与LYM和异型淋巴细胞比例之间的关系。结果 IM组患儿淋巴结肿大比例、咽峡炎比例、眼睑水肿比例、肝脾肿大比例、皮疹比例、WBC、LYM、ALT、AST、异型淋巴细胞比例、β2-MG、ADA水平高于非IM组(P<0.05),NEU水平低于非IM组(P<0.05);WBC、LYM、ALT、AST、异型淋巴细胞比例、β2-MG、ADA是IM发生的危险因素(P<0.05),NEU与IM无关(P>0.05);β2-MG、ADA及二者联合诊断IM的AUC分别为0.839、0.822、0.927,联合诊断价值最高;相比于IM急性期患儿,恢复期患者β2-MG、ADA水平降低(P<0.05);IM儿童β2-MG、ADA与LYM、异型淋巴细胞比例均成正相关(P<0.05)。结论 血β2-MG、ADA是儿童IM的危险因素,在早期诊断IM方面有潜在价值。Objective This paper aims to investigate the changes and significance of bloodβ2-microglobulin(β2-MG)and adenosine deaminase(ADA)in children with infectious mononucleosis(IM).Methods The clinical data of 86 children with IM admitted to our hospital from January 2021 to December 2022 were retrospectively analyzed,77 children with respiratory diseases admitted during the same period were selected as the non-IM group,and the general data and laboratory indicators of the two groups were compared.Logistic regression was used to analyze the relationship between laboratory indicators and IM,and receiver operating characteristic curve(ROC)was used to analyze the value of laboratory indicators in diagnosing IM.The levels ofβ2-MG and ADA in IM children at different disease stages were compared,and Pearson correlation analysis was carried out on the relationship betweenβ2-MG,ADA,LYM and proportion of heteromorphic lymphocyte.Results The proportions of lymphadenectasis,isthmopyra,palpebral edema,hepatosplenomegaly,rashproportion,WBC,LYM,ALT,AST,atypical lymphocyte,and the levels ofβ2-MG and ADA in IM group were higher than those in non-IM group(P<0.05);NEU level in IM group was lower than that of non-IM group(P<0.05).WBC,LYM,ALT,AST,allotypic lymphocyte proportions and the levels of,β2-MG and ADA were risk factors for IM(P<0.05).There was no correlation between NEU and IM(P<0.05).The AUC values ofβ2-MG,ADA and their combined detections were 0.839,0.822 and 0.927,respectively,and the combined detection showed the highest diagnostic value.The levels ofβ2-MG and ADA in convalescent patients were decreased compared to those in the acute stage of IM(P<0.05).The levels ofβ2-MG and ADA in IM children were positively correlated with LYM and atypical lymphocytes proportion(P<0.05).Conclusion Bloodβ2-MG and ADA are significantly correlated with IM,which has potential value in early diagnosis of IM.

关 键 词：Β2-微球蛋白 腺苷脱氨酶 传染性单核细胞增多症 EB病毒 诊断价值 

分 类 号：R512.7[医药卫生—内科学]