肾病综合征患儿EB病毒和淋巴细胞亚群变化及其与病情进展的关系  

Changes in Epstein-Barr virus infection and lymphocyte subsets in children with nephrotic syndrome and their associations with disease progression

作　　者：陈玉婷 张诗海 张晨宇 袁春艳 CHEN Yuting;ZHANG Shihai;ZHANG Chenyu;YUAN Chunyan(Department of Clinical Laboratory,Anhui Provincial Children s Hospital,Anhui Hefei 230001,China)

机构地区：[1]安徽省儿童医院检验科,安徽合肥230001

出　　处：《中国妇幼健康研究》2025年第3期72-78,共7页Chinese Journal of Woman and Child Health Research

基　　金：安徽省医科大学校科研基金项目(2022xkj243)。

摘　　要：目的观察肾病综合征(NS)患儿EB病毒(EBV)和淋巴细胞亚群变化,并分析两者与病情进展的关系。方法选取2020年8月至2022年8月安徽省儿童医院收治的NS患儿79例纳入NS组,另选取同期于本院体检的健康儿童79例纳入对照组。比较对照组、NS组EBV-脱氧核糖核酸(DNA)载量与淋巴细胞亚群变化;用Pearson相关性分析法分析NS组EBV-DNA载量与淋巴细胞亚群的相关性;根据激素敏感情况将NS患儿分为敏感组、抵抗组,根据是否复发将患儿分为未复发组、复发组、频繁复发组,比较各组EBV-DNA载量与淋巴细胞亚群变化。结果与对照组相比,NS组EBV-DNA、EBV抗体衣壳抗原免疫球蛋白M抗体(VCA-IgM)、衣壳抗原免疫球蛋白G抗体(VCA-IgG)阳性率,以及EBV-DNA载量、CD8^(+)T淋巴细胞构成比升高,CD3^(+)、CD4^(+)T淋巴细胞构成比及CD4^(+)/CD8^(+)比值降低,差异均有统计学意义(χ^(2)/t值介于4.674~28.535之间,P<0.05);Pearson相关性分析法显示,NS组EBV-DNA载量与CD8^(+)T淋巴细胞构成比表现为正相关性(r=0.595,P<0.05),与CD3^(+)、CD4^(+)T淋巴细胞构成比及CD4^(+)/CD8^(+)比值表现为负相关性(r值分别为-0.642、-0.557、-0.657,P<0.05);与敏感组比较,抵抗组EBV-DNA、抗VCA-IgM、抗VCA-IgG阳性率,以及EBV-DNA载量、CD8^(+)T淋巴细胞构成比升高,CD3^(+)、CD4^(+)T淋巴细胞构成比及CD4^(+)/CD8^(+)比值降低,差异均有统计学意义(χ^(2)/t值介于2.194~6.254之间,P<0.05);未复发组、复发组、频繁复发组的EBV-DNA、抗VCA-IgM、抗VCA-IgG阳性率,以及EBV-DNA载量、CD8^(+)T淋巴细胞构成比依次升高,CD3^(+)、CD4^(+)T淋巴细胞构成比及CD4^(+)/CD8^(+)比值依次降低,差异均有统计学意义(χ^(2)/F值介于7.595~31.882之间,P<0.05)。结论EBV感染、淋巴细胞亚群变化与肾病综合征发生及病情进展密切相关,且两者具有显著相关性。Objective To investigate changes in Epstein-Barr virus(EBV)infection and lymphocyte subsets in children with nephrotic syndrome(NS),and to analyze associations of EBV load and lymphocyte subsets with disease progression.Methods A total of 79 children with NS who admitted to Anhui Provincial Children s Hospital from August 2020 to August 2022 were enrolled in NS group,and 79 age-matched healthy children who underwent physical examination in our hospital during the same period were selected as controls.The changes in EBV-deoxyribonucleic acid(DNA)load and lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)T cells,and CD4^(+)/CD4^(+)ratio)were compared between the two groups.Pearson correlation analysis was used to analyze association between EBV-DNA load and lymphocyte subsets in the NS group.The patients were further stratified according to steroid sensitivity(steroid-sensitive group and steroid-resistant group)and relapse status(non-relapse group,relapse group and frequent relapse group)for subgroup comparisons.Results Compared with the control group,the positive rates of EBV-DNA,EBV antibody capsid antigen immunoglobulin M antibody(VCA-IgM)and EBV capsid antigen immunoglobulin G antibody(VCA-IgG),EBV-DNA load and CD8^(+)T lymphocyte constituent ratio in the NS group elevated,while CD3^(+),CD4^(+)T lymphocyte constituent ratio and CD4^(+)/CD8^(+)ratio descended,and the differences were statistically significant(χ^(2)/t value ranged from 4.674 to 28.535,all P<0.05).Pearson correlation analysis showed that in the NS group EBV-DNA load was positively correlated with CD4^(+)T lymphocyte constituent ratio(r=0.595,P<0.05),while negatively correlated with CD3^(+),CD4^(+)T lymphocyte constituent ratios and CD4^(+)/CD4^(+)ratio(r=-0.642,-0.557 and-0.657 respectively,all P<0.05).Compared with the steroid sensitive group,the positive rates of EBV-DNA,anti-VCA-IgM and anti-VCA-IgG,EBV-DNA load and CD4^(+)T lymphocyte constituent ratio increased in the steroid resistant group,while the CD3^(+),CD4^(+)T lymphocyte constituent ratios a

关 键 词：肾病综合征 儿童 EB病毒 淋巴细胞亚群 复发 

分 类 号：R179[医药卫生—妇幼卫生保健]