EB病毒抗体和DNA联合检测可提高儿童传染性单核细胞增多症的诊断灵敏度

Combined detection of Epstein-Barr virus antibodies and DNA can improve the diagnosis sensitivity in pediatric mononucleosis

目的评估EB病毒抗体VCA-IgM、VCA-IgG、EA-IgG、EBNA-1-IgG及EBV-DNA载量检测在儿童传染性单核细胞增多症(传单)中的诊断意义。方法用ELISA方法检测70例传单患儿和25例健康儿童血清中EBV四种抗体及PCR荧光定量法检测外周血单个核细胞EBV-DNA载量。结果传单患儿组EBV-DNA的阳性率为87.14%(61/70),对照组阳性率为8.00%(2/25),传单组与对照组EBV-DNA的阳性率比较差异有统计学意义(P<0.01)。EBV抗体检测中,传单组的VCA-IgM阳性率最高,达91.43%(64/70),对照组VCA-IgM全部阴性。传单组EB病毒VCA-IgM和EBV-DNA联合检测的阳性率97.1%。结论 EBV抗体和EBV-DNA载量检测对儿童传单的诊断有极高的价值,尤其是VCA-IgM抗体和EBV-DNA联合检测,可提高儿童传单的临床诊断的敏感性。

Objective To evaluate the diagnosis sensitivity of Epstein-Barr virus（EBV）DNA and four antibodies（VCA-IgM,VCA-IgG,EA-IgG and EBNA-1-IgG） in pediatric infectious mononucleosis（IM）.Method EBV-DNA of peripheral blood samples from 70 pediatric IM patients and 25 healthy children were analyzed by fluorescence quantitative polymerase chain-eaction（FQ-PCR）.Four antibodies were detected by ELISA method.Result The positive rate of EBV-DNA in IM group was 87.14%（61/70） and 8.00%（2/25） in the control group;the positive rate of former was significantly higher than that of the latter（P0.01）.IM group had a 91.43%（64/70） VCA-IgM positive rate,while control group＇s VCA-IgM were negative.The positive rate of VCA-IgM and EBV-DNA were almost all positive in IM group at 97.1%.Conclusion The EBV antibodies and DNA load have a high value to the IM diagnosis,particularly to the united examination of VCA-IgM,and EBV-DNA may improve diagnosis sensitivity of pediatric infectious mononucleosis.