血清EB病毒抗体联合血清白介素-27、Toll样受体4检查在传染性单核细胞增多症诊断中的应用  

Application of serum EB virus antibody combined with serum IL-27 and TLR4 testing in the diagnosis of infectious mononucleosis

作　　者：刘婷 桑娟 高思洋 金泉 王丽艳 倪文昌 Liu Ting;Sang Juan;Gao Siyang;Jin Quan;Wang Liyan;Ni Wenchang(Department of Pediatrics,Wuhan Third Hospital Pediatrics,Hubei Wuhan 437600;Department of Pediatrics,China University of Geosciences(Wuhan)Hospital,Hubei Wuhan 430010,China)

机构地区：[1]武汉市第三医院儿科,湖北武汉437600 [2]中国地质大学(武汉)医院儿科,湖北武汉430010

出　　处：《新发传染病电子杂志》2025年第1期39-43,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：武汉市中医药科研项目立项(WZ22C17)。

摘　　要：目的探究血清EB病毒(Epstein-Barr virus,EBV)抗体IgM/IgG(viral capsid protein-immunoglobulin M/viral capsid protein-immunoglobulin G,VCA-IgM/IgG)联合白介素-27(interleukin 27,IL-27)、Toll样受体4(Toll-like receptor 4,TLR4)检测在传染性单核细胞增多症(infectious mononucleosis,IM)诊断中的应用。方法选取武汉市第三医院在2022年3月至2024年3月期间就诊且符合研究条件的58例IM患者为研究对象(IM组),另取同期体检健康者60例作为对照组。采用全自动化学发光仪以及配套试剂进行VCA-IgM/IgG检测。采用ELISA法检测血清中IL-27、TLR4的蛋白表达;Spearman法分析血清VCA-IgM/IgG、IL-27、TLR4水平与IM患者疾病分期的相关性;ROC曲线分析血清VCA-IgM/IgG、IL-27和TLR4水平对IM患者的诊断价值。结果IM组的VCA-IgM/IgG阳性率显著高于对照组的阳性率(P<0.05),血清IL-27和TLR4水平显著高于对照组(均P<0.05)。前、中、后期患者血清VCA-IgM/IgG阳性率及IL-27、TLR4水平均呈逐渐升高趋势(均P<0.05)。血清VCA-IgM/IgG、IL-27、TLR4水平与IM患者疾病分期呈正相关(P<0.05)。VCA-IgM/IgG、IL-27、TLR4是发生IM的独立影响因素(P<0.05)。血清VCA-IgM/IgG、IL-27和TLR4单独检测IM的敏感度分别为74.14%、81.03%、68.97%,特异度分别为80.00%、86.67%、91.67%,三者联合诊断IM的敏感度为93.10%,特异度为78.33%,准确率为85.59%,与临床诊断一致性较高(Kappa值=0.713,P<0.001)。结论血清VCA-IgM/IgG阳性表达率及IL-27、TLR4水平在IM患者中均升高,三者联合对IM患者具有较高的诊断价值。Objective To explore the application of serum EB virus(EBV)antibody viral capsid protein-immunoglobulin M/viral capsid protein-immunoglobulin G(VCA-IgM/IgG)combined with interleukin-27(IL-27)and Toll-like receptor 4(TLR4)testing in the diagnosis of infectious mononucleosis(IM).Method From March 2022 and March 2024,58 patients with IM who visited our hospital and met the research criteria were included as the study subjects,and 60 healthy individuals who underwent physical examinations were included as the control group.Fully automatic chemiluminescence analyzer and supporting reagents were applied for VCA-IgM/IgG detection.ELISA method was applied to detect the protein expression of IL-27 and TLR4 in serum.Spearman method was applied to analyze the correlation between serum VCA-IgM/IgG,IL-27,TLR4 levels and disease staging in IM patients.ROC curve was applied to analyze the diagnostic value of serum VCA-IgM/IgG,IL-27,and TLR4 levels in IM patients.Result The positive rate of VCA-IgM/IgG in the IM group was obviously higher than that in the control group(P<0.05),and the levels of serum IL-27 and TLR4 were obviously higher than those in the control group(P<0.05).The positive rate of serum VCA-IgM/IgG and the levels of IL-27 and TLR4 in patients in the early,middle,and late stages showed a gradually increasing trend(P<0.05).The levels of serum VCA-IgM/IgG,IL-27,and TLR4 were positively correlated with the disease staging of IM patients(P<0.05).VCA-IgM/IgG,IL-27,and TLR were independent influencing factors for the occurrence of IM(P<0.05).The sensitivity of detecting IM with serum VCA-IgM/IgG,IL-27,and TLR4 alone was 74.14%,81.03%,and 68.97%,respectively,the specificity was 80.00%,86.67%,and 91.67%,respectively,the sensitivity,specificity,and accuracy of the combined diagnosis for IM were 93.10%,78.33%,and 85.59%,respectively,which were consistent with clinical diagnosis(Kappa value=0.713,P<0.001).Conclusion The positive expression rate of serum VCA-IgM/IgG and the levels of IL-27 and TLR4 are all elevated in IM pati

关 键 词：EB病毒抗体 白介素-27 TOLL样受体4 传染性单核细胞增多症 诊断 

分 类 号：R512.7[医药卫生—内科学]