补体C3、C4及免疫球蛋白与传染性单核细胞增多症患儿EBV-DNA载量关系及联合诊断效能  

Relationship between C3,C4,Immunoglobulin and EBV-DNA Load in Children with Infectious Mononucleosis and Efficacy of Combined Diagnosis

作　　者：何婧 肖长水[1] 舒立 HE Jing;XIAO Changshui;SHU Li(Department of Pediatrics,Ningguo People's Hospital,Ningguo,Anhui 242300,China)

机构地区：[1]宁国市人民医院儿科,安徽宁国242300

出　　处：《临床误诊误治》2024年第11期76-82,共7页Clinical Misdiagnosis & Mistherapy

基　　金：2022年度安徽省卫生健康科研项目(AHWJ2022c006)。

摘　　要：目的探讨补体C3、C4及免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM与传染性单核细胞增多症(infec-tious mononucleosis,IM)患儿EB病毒(epstein-barrvirus,EBV)-DNA载量的关系及联合诊断效能。方法选取2020年6月至2023年12月收治的76例IM患儿作为研究组,另按照1:1原则选择76例健康儿童作为对照组。比较2组不同性别、年龄、病程、系统损伤个数、EBV-DNA载量患儿血清补体C3、C4及IgA、IgG、IgM水平,采用Spearman分析IM患儿病程、系统损伤个数、EBV-DNA载量与血清补体C3、C4及IgA、IgG、IgM的相关性,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析各指标单一及联合诊断IM的效能。结果与对照组比较,研究组血清补体C3.C4及IgA、IgG、IgM水平较高(P<0.01);研究组血清补体C3、C4及IgA、IgG、IgM水平比较:急性期>恢复期,1个系统损伤<多于1个系统损伤,EBV-DNA高载量>中等载量低载量,差异有统计学意义(P<0.01);IM患儿病程与血清补体C3、C4及IgA、IgG、IgM呈负相关,系统损伤个数、EBV-DNA载量与血清补体C3、C4及IgA、IgG、IgM呈正相关(P<0.01);血清IgA、IgG、IgM联合补体C3和(或)C4及五者联合诊断IM的曲线下面积(areaundercurve,AUC)优于各指标单一诊断的AUC,其中IgA+IgG+IgM+补体C4+补体C3联合为最佳组合,敏感度为0.908、特异度为0.842。结论IM患儿血清补体C3、C4及IgA、IgG、IgM水平异常升高,且与患儿病程、系统损伤个数、EBV-DNA载量密切相关;血清补体C3、C4及IgA、IgG、IgM联合诊断IM具有较高的价值。Objective To investigate the relationship between complement 3(C3),complement 4(C4),immunoglobu-lin(Ig)A,IgG,IgM and Epstein-Barr virus(EBV)-DNA load in children with infectious mononucleosis(IM)and the combined diagnostic efficacy.MethodsA total of 76 children with IM treated from June 2020 to December 2023 were selected as the research group,and 76 healthy children were selected as the control group at a ratio of 1:1.The expression of serum C3,C4,IgA,IgG and IgM were compared among those with different gender,age,course of disease,number of systemic damage and EBV-DNA load between the two groups.The correlation between the course of disease,number of systemic damage,EBV-DNA load and serum C3,C4,IgA,IgG and IgM in children with IM was analyzed by Spearman analysis.Receiver operating charac-teristic(ROC)curve was drawn to analyze the efficacy of the above indicators alone and in combination in the diagnosis of IM.Results Compared with the control group,the levels of serum C3,C4,IgA,IgG and IgM in the research group were higher(P<0.01).The expressions of serum C3,C4,IgA,IgG and IgM in the research group were as follows:acute stage>recovery stage,1 system injury<more than 1 system injury,EBV-DNA high load>medium load>low load,and the difference was statis-tically significant(P<0.01).The course of disease of IM children was negatively correlated with serum C3,C4,IgA,IgG and IgM,while the number of systemic damage and EBV-DNA load were positively correlated with serum C3,C4,IgA,IgG and IgM(P<0.01).The area under the ROC curve(AUC)of serum IgA,IgG and IgM combined with C3 and/or C4 or the combination of the above five indicators in the diagnosis of IM was better than that of single indicator,and IgA+IgG+IgM+C4+C3 was the opti-mal combination,with the sensitivity of 0.908 and the specificity of 0.842.Conclusion The abnormal expression of C3,C4,IgA,IgG and IgM in children with IM is closely related to the course of disease,the number of systemic damage and EBV-DNA load.Serum C3,C4,IgA,IgG,and IgM in combination has a hi

关 键 词：传染性单核细胞增多症 儿童 补体C3 补体C4 免疫球蛋白 病程 病毒载量 相关性 诊断效能 

分 类 号：R725.1[医药卫生—儿科]