血液病患者人微小病毒B19感染特征分析  

Characteristic analysis of human parvovirus B19 infection in patients with hematological disease

作　　者：魏崴 王蕾[1] 赵益民[2] WEI Wei;WANG Lei;ZHAO Yimin(Department of Laboratory,Shanghai Eighth People’s Hospital,Shanghai 200235,China;Key Laboratory of Thrombosis and Hemostasis of Ministry of Health,Jiangsu Institute of Hematology,the First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]上海市第八人民医院检验科,上海200235 [2]苏州大学附属第一医院,江苏省血液研究所,卫生部血栓与止血重点实验室,苏州215006

出　　处：《中国临床医学》2025年第1期78-84,共7页Chinese Journal of Clinical Medicine

基　　金：上海市徐汇区医学重点学科(SHXHZDXK202322).

摘　　要：目的探讨血液病患者人微小病毒B19(HPV-B19)的感染情况及临床特征。方法选择2019年2月至2020年2月在上海市第八人民医院就诊的94例良性血液病患者、128例血液肿瘤患者和89名健康体检者,采用ELISA以及PCR检测其血浆HPV-B19特异性抗体IgM及核酸水平。比较3组HPV-B19的感染率,以及血液病患者中HPV-B19阳性与阴性者的临床特征。结果良性血液病患者HPV-B19 IgM阳性率为9.6%(9/94)、核酸阳性率为11.7%(11/94)、总体感染[IgM和(或)核酸阳性]率为14.9%(14/94);血液肿瘤患者HPV-B19 IgM阳性率为18.0%(23/128)、核酸阳性率为19.5%(25/128)、总体感染率为26.6%(34/128);健康对照组HPV-B19 IgM阳性率为1.1%(1/89)、核酸阳性率为2.2%(2/89)、总体感染率为2.2%(2/89)。良性血液病患者HPV-B19总体感染率高于健康对照组(P=0.006);血液肿瘤患者总体感染率高于良性血液病患者(P=0.037)及健康对照组(P<0.001)。良性血液病中,纯红细胞再生障碍性贫血(PRCA)、自身免疫性溶血性贫血(AIHA)、免疫性血小板减少性紫癜(ITP)和再生障碍性贫血(AA)患者HPV-B19感染率较高,分别为44.4%(4/9)、27.3%(3/11)、25.0%(4/16)和21.4%(3/14);血液肿瘤中,非霍奇金淋巴瘤(NHL)和慢性淋巴细胞白血病(CLL)的HPV-B19感染率最高,分别为42.9%(9/21)和37.5%(6/16)。两血液病组患者中,HPV-B19阳性者年龄更大(P<0.05);NHL、CLL及多发性骨髓瘤(MM)患者中,HPV-B19阳性者的网织红细胞占比降低(P<0.05);NHL、急性髓系白血病(AML)、急性淋巴细胞白血病(ALL)患者中,HPV-B19阳性者化疗后骨髓抑制时间延长(P<0.05)。结论血液病患者HPV-B19感染率升高,HPV-B19感染影响患者病情及治疗。Objective To explore the infection status and clinical characteristics of human parvovirus B19(HPV-B19)in patients with hematological disease.Methods A total of 94 patients with benign hematological disease,128 patients with hematological malignancy,and 89 healthy individuals at Shanghai Eighth People’s Hospital from February 2019 to February 2020 were selected.The levels of specific IgM and nucleic acid of HPV-B19 in the plasma were detected using ELISA and PCR.The infection rates among the 3 groups and clinical characteristics between HPV-B19 positive and negative patients with hematological disease were compared.Results The positive rate of HPV-B19 IgM was 9.6%(9/94),the positive rate of nucleic acid was 11.7%(11/94),and the overall infection rate of HPV-B19(IgM and/or nucleic acid positive)was 14.9%(14/94)in benign group of patients.The positive rate of HPV-B19 IgM was 18.0%(23/128),the positive rate of nucleic acid was 19.5%(25/128),and the overall infection rate of HPV-B19 was 26.6%(34/128)in malignant group of patients.The positive rate of HPV-B19 IgM was 1.1%(1/89),the positive rate of nucleic acid was 2.2%(2/89),and the overall infection rate of HPV-B19 was 2.2%(2/89)in healthy controls.The overall HPV-B19 infection rate in benign group of patients was higher than that in healthy controls(P=0.006).The overall HPVB19 infection rate was higher in malignant group of patients than that in benign group of patients(P=0.037)and healthy controls(P<0.001).In the benign group,the HPV-B19 infection rates in patients with pure red cell aplasia(PRCA),autoimmune hemolytic anemia(AIHA),immune thrombocytopenic purpura(ITP),and aplastic anemia(AA)were higher,with 44.4%(4/9),27.3%(3/11),25.0%(4/16),and 21.4%(3/14),respectively.In the malignant group,the HPV-B19 infection rates in patients with non-Hodgkin lymphoma(NHL)and chronic lymphocytic leukemia(CLL)were higher,with 42.9%(9/21)and 37.5%(6/16),respectively.The HPV-B19 positive patients in both hematological disease groups were older(P<0.05).In patients with NHL,CLL

关 键 词：血液病 血液肿瘤 人微小病毒B19 骨髓抑制 

分 类 号：R552[医药卫生—血液循环系统疾病]