细小病毒B19感染患者临床特征及预后分析  

Clinical characteristics and prognostic analysis of patients infected with Parvovirus B19

作　　者：马帅 尹玉瑶 郭一凡 殷冠坤 陈宏斌[2] 王辉[2] Ma Shuai;Yin Yuyao;Guo Yifan;Yin Guankun;Chen Hongbin;Wang Hui(Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China;Department of Clinical Laboratory,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学医学部医学技术研究院,北京100191 [2]北京大学人民医院检验科,北京100044

出　　处：《中华检验医学杂志》2024年第6期672-677,共6页Chinese Journal of Laboratory Medicine

基　　金：2022年度北京市重大疫情防治重点专科卓越项目。

摘　　要：目的探究感染细小病毒B19(B19V)的住院患者特征及B19V对患者疾病进展和临床结局的潜在影响。方法本研究为一项观察性回顾性研究。研究对象为2022年4月1日至2023年8月31日于北京大学人民医院就诊,并进行病原体宏基因组测序技术(mNGS)的3129例住院患者中检测为B19V阳性的62例患者。收集了这些患者的病原检测数据及相关的临床特征与临床结局并结合其他实验室检测结果对患者的住院时间、住院期间的混合感染情况及30 d内的临床结局进行综合评估。并使用χ^(2)检验对患者病死率与其他相关因素间的差异进行统计分析。结果B19V感染最常见于血液病患者和实体器官移植患者(79.03%,49/62)。且B19V与其他病原体混合感染40例,其中混合感染频率较高的是细环病毒20例,巨细胞病毒9例和EB病毒8例。B19V最常见的检出部位是外周血(χ^(2)=0.0003,P<0.001),但在体液样本中也有部分检出。B19V感染30 d内患者病死率为19.35%(12/62),10/12的死亡患者同时伴随其他病原混合感染,且B19V混合感染比仅B19V感染的患者死亡率更高(χ^(2)=4.546,P<0.05)。对多次进行mNGS检测的24例患者结果对比分析显示,相比一过性B19V感染患者(12例),长期B19V感染患者(12例)病死率更高(χ^(2)=12,P<0.001)。结论B19V感染在血液病患者和实体器官移植患者中较为常见,且通常与其他病原体混合感染。患者感染B19V后30 d内的病死率较高,尤其是伴随其他病原混合感染的情况下,病死率更高,且长期持续感染B19V的患者生存风险增加。Objective Investigate the characteristics of hospitalized patients infected with parvovirus B19(B19V)and the potential impact of B19V on disease progression and clinical outcomes in patients.Methods The subjects of this observational retrospective study were 62 hospitalized patients who tested positive for B19V among 3129 inpatients who visited Peking University People′s Hospital between April 1,2022,and August 31,2023,and underwent metagenomic next-generation sequencing(mNGS)for pathogens.Patient data regarding pathogen detection,clinical characteristics,and outcomes were collected,along with other laboratory test results,to assess hospitalization duration,incidence of mixed infections during hospitalization,and clinical outcomes within 30 days.The chi-square test was utilized to analyze differences in patient mortality rates and other relevant factors.Results B19V infection waspobserved in patients with hematological disorders and solid organ transplant recipients(79.03%,49/62).Additionally,B19V frequently coexists with other pathogens(40/62),with the highest rates of mixed infections involving human herpesvirus 6,cytomegalovirus,and Epstein-Barr virus,having 20,9,and 8 cases respectively.The most common site of B19V detection is peripheral blood(χ^(2)=0.0003,P<0.001),although it can also be detected in other bodily fluid samples.The 30 day mortality rate among B19V infected patients was 19.35%(12/62)10 out of 12 deceased patients had concurrent mixed infections with other pathogens.Moreover,patients with mixed B19V infections exhibited a higher mortality rate compared to those with B19V infection alone(χ^(2)=4.546,P=0.033).Comparative analysis of 24 patients who underwent multiple mNGS tests revealed that patients with chronic B19V infection(12 cases)had a higher mortality rate compared to those with transient B19V infection(12 cases)(χ^(2)=12,P<0.001).Conclusions Parvovirus B19(B19V)infection is more commonly observed in patients with hematological disorders and solid organ transplant recipients,often co

关 键 词：病毒感染 细小病毒B19 病毒组 高通量测序 

分 类 号：R511[医药卫生—内科学]