EB病毒在儿童腺样体肥大和扁桃体炎组织内的定量研究及意义

Study and analysis on the quantitive detection of EBV-DNA in adenoidal hypertrophic and tonsillitis tissues of children

目的:探讨EB病毒在儿童慢性扁桃体炎、腺样体肥大中的流行病学特点及其在儿童腺样体肥大、慢性扁桃体炎疾病发病机制中的作用。方法:采用实时荧光定量PCR技术对52例慢性扁桃体炎、腺样体肥大患儿手术摘除的腺样体、扁桃体组织及血浆标本进行EB病毒定量检测。结果:患有慢性扁桃体炎和(或)腺样体肥大的儿童扁桃体、腺样体组织中EB病毒感染率为51.9%;其中男性患儿EB病毒感染率为50.0%,女性患儿为55.6%,两者差异无统计学意义(P>0.05)。扁桃体组织EB病毒感染率为40.4%,腺样体组织为48.9%,差异无统计学意义(P>0.05)。学龄组(7～14岁)患儿扁桃体和腺样体组织EB病毒感染率为65.5%,明显高于学龄前组(2～6岁)患儿的感染率(34.8%)。比较轻、中、重度肥大的腺样体组织中EB病毒-DNA拷贝数发现:重度肥大组EB病毒-DNA拷贝数明显高于其他两组(P<0.05)。52例患儿血浆标本检测发现:EB病毒-DNA拷贝数均在正常范围内(<1×103 copies/ml)。结论:腺样体肥大组织与慢性扁桃体炎组织对EB病毒有相同的易感性,男、女性患儿的扁桃体和腺样体组织对EB病毒易感性基本相同,且随着患儿年龄的增长、病程的延长,EB病毒的感染率也会相应增高。腺样体的增生、肥大与EB病毒的感染有一定相关性。

Objective：To investigate the epidemiology of EBV in adenoidal hypertrophy and chronic tonsillitis and discuss the effection of EBV on the nosogenesis of adenoidal hypertrophy and tonsillitis of children.Method：Fifty-two children with chronic tonsillitis and/or adenoidal hypertrophy had the operations of the tonsillectomy and/or the adenoidectomy. These tissues resected and plasma of all cases were detected to find EBV-DNA by RQ-PCR.Result：The infection rate of EBV in the tissues of adenoidal hypertrophy and tonsillitis of childen was 51.9%. The boys＇ infection rate of EBV was 50.0%,and the girls＇ infection rate of EBV was 55.6%,which had not significantly different. The EBV infection rate in the tissues of tonsillitis was 40.4%,The EBV infection rate in the tissues of adenoidal hypertrophy was 48.9%,which had not significant difference. The school age group（ 7 to 14 years old） presented higher infection rate of EBV in the tissues of adenoid and tonsil （65.5%） than the preschool children group（2 to 6 years old）（34.8%）.Comparing the copies numbers of EBV-DNA in the different degrees of adenoidal hypertrophy,we found that the copies numbers of EBV-DNA in the severe hypertrophy group were higher than the midrange and slight hypertrophy groups（P〈0.05）. Meanwhile we detected EBV-DNA in these childrens＇ blood plasma by RQ-PCR. No blood plasma was detected EBV-DNA copies higher than normal （〈1×10^3 copies/ml）.Conclusion：The tissues of adenoidal hypertrophy and tonsillitis had same sensitivity to EBV. There was not significant difference between the infection rates of the boys and girls with adenoidal hypertrophy and/or tonsillitis. With these children growing up and the course of diseases prolonging,the infection rate of EBV increased correspondingly. There was a certain correlation between the hypertrophy of adenoid and EBV. There were no EBV-DNA fragments in blood plasma of the children with adenoidal hypertrophy and/or tonsillitis. So there were essential different between benign hyperplasy and nasopharyngeal carcinoma.