传染性单核细胞增多症和慢性活动性EB病毒感染淋巴细胞亚群变化  

Summarize Lymphocyle Subsets in Children with EBV Infectious Mononucleosis(IM)and Chronic Active Epstein-Barr Virus Infection

作　　者：钱冰涛 刘芳 毕淑英 王晶[1] 王泽芯 宋庆[1] QIAN Bing-tao;LIU Fang;BI Shu-ying;WANG Jing;WANG Ze-xin;SONG Qing(Department of Pediatrics,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院儿科,北京100049

出　　处：《罕少疾病杂志》2025年第4期148-151,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨EB病毒感染所致的儿童传染性单核细胞增多症(IM)和慢性活动性EB病毒感染(CAEBV)两组外周血中淋巴细胞亚群变化并且对比两组外周血EBVDNA水平,探讨EBV感染导致的传染性单核细胞增多症发展为慢性活动性EB病毒感染的高危因素。方法选取航天中心医院2015年1月至2021年8月儿科病房住院并确诊为EBV感染的IM115例和CAEBV13例的临床资料及实验室检测结果进行回顾性分析,分析感染EB病毒后的传染性单核细胞增多症和慢性活动性EBV感染患儿的临床特点。选取同期体检健康儿童73例比较患儿感染EBV后淋巴细胞亚群的变化,采用Python软件方法统计学分析,配对t检验比较组间差异。结果传染性单核细胞增多症(IM)115例、慢性活动性EB病毒感染(CAEBV)13例及对照组正常儿童73例外周血中淋巴细胞免疫亚群。采用配对t检验分别比较3组淋巴细胞亚群的变化是否有统计学差异。IM组CD3、CD8、NK细胞绝对值显著高于对照组(P<0.05),差异有统计学意义;IM组CD4、B淋巴绝对值显著低于对照组(P<0.05),差异有统计学意义。CAEBV组CD3、CD4、CD8、B淋巴、NK细胞绝对值显著低于对照组(P<0.05),差异有统计学意义。CAEBV组CD3、CD4、CD8、B淋巴、NK细胞绝对值显著低于IM组(P<0.05),差异有统计学意义。结论EB病毒感染引起的IM患儿存在免疫失衡,IM患儿外周血中CD8+T和总CD3细胞在明显增多,CD4、B淋巴细胞较正常儿童相对减少。而CAEBV儿童存着严重免疫功能紊乱和免疫功能低下,CD3、CD4、CD8、B淋巴、NK细胞计数均明显低于正常儿童和IM组。EB病毒感染的患儿检测外周血中淋巴细胞亚群变化、EB病毒核酸载量有助于鉴别诊断和评估病情。Objective To compare the characteristics of peripheral blood lymphocyte subsets and EBV-DNA levels in children with EBV infectious mononucleosis(IM)and chronic active Epstein-Barr virus infection(CAEBV),which explore the high risk factors of EBV infectious mononucleosis developing into chronic active EB virus infection.Methods The clinical data and laboratory test results of IM 115 patients and 13 CAEBV patients in pediatrics of the Aerospace Center Hospital from January 2015 to August 2021 were retrospectively analyzed.The clinical characteristics of IM and CAEBV children were analyzed.73 healthy children in the same period were selected to compare the changes of lymphocyte subsets after EBV infection.The changes of EBVDNA,lymphocyte subpopulation were detected and compared among the three groups.Results There were 115 cases of infectious mononucleosis(IM),13 cases of chronic active EB virus infection(CAEBV)and 73 cases of normal children in the control group.Paired t-test was used to compare the changes of lymphocyte subsets in the three groups.The absolute values of CD3,CD8 and NK cells in IM group were significantly higher than those in control group(P<0.05).The absolute values of CD4 and B lymphocytes in IM group were significantly lower than those in control group(P<0.05).The absolute values of CD3,CD4,CD8,B lymphocytes and NK cells in CAEBV group were significantly lower than those in the control group(P<0.05).The absolute values of CD3,CD4,CD8,B lymphocytes and NK cells in CAEBV group were significantly lower than those in IM group(P<0.05).Conclusion There is an imbalance in lymphocyle subsets and disturbance in cellular immunity in children with EBV infectious,which maybe associated with actively EBV infection.CD8 and CD3 cells in IM children were significantly increased compared with normal children,and CD4 and B lymphocytes were relatively reduced.However,CAEBV children had severe immune dysfunction and low immune function.The counts of CD3,CD4,CD8,B lymphocytes and NK cells were significantly lower th

关 键 词：EB病毒 传染性单核细胞增多症 慢性活动性EB病毒感染 淋巴细胞亚群 儿童 

分 类 号：R512.7[医药卫生—内科学]