间接免疫荧光法检测EBV抗体谱在儿童EB病毒感染中的临床应用

Clinical Application of Indirect Immunofluorescence Assay in Detection of EBV Antibody Spectrum Among Children with Epstein-Barr Virus Infection

目的探讨间接免疫荧光法(IFA)检测EBV抗体谱在儿童EB病毒感染中的应用价值。方法对1 653例疑似EB病毒感染的发病儿童采用间接免疫荧光法(IFA)联合检测EBV-CA IgG抗体及亲和力、EBV-CA IgM、EBV-EA IgG、EBNA IgG,分析EBV感染时期,探讨其与疾病的相关性。结果 1 653例疑似EB病毒感染的发病儿童组中,发生EBV感染的病例数为1 485例(90.0%),其中EBV原发感染(急性期)301例(18.2%),EBV复发感染(急性期)423例(25.6%),EBV既往感染761例(46.0%),无EBV感染168例(10.0%)。724例患儿EBV感染(包括EBV原发感染急性期、EBV复发感染急性期)的相关疾病涉及呼吸、消化、血液、循环等系统,主要有急性上呼吸道感染238例(32.9%),急性扁桃体炎236例(32.6%),肺炎82例(11.3%),发热查因104例(14.4%);儿童EB病毒原发感染与复发感染发生的年龄分布基本一致,以8岁以内患儿,尤其是4岁以内的患儿为主,所致疾病均以呼吸系统疾病为主。EB病毒复发感染比原发感染所致疾病类型更复杂。EB病毒原发感染(急性期)EBV-CA IgM抗体阳性率仅为16.0%。结论EBV抗体谱检测可以综合判断出EBV感染时期,区分EBV急性感染与既往感染,其敏感性高、特异性强、明确诊断,值得推广。

Objective To explore the clinical value of indirect immunofluorescence assay （IFA） in detecting＇ EBV anti- body profile in children with Epstein- Barr virus （EBV） infection. Methods A total of 1,653 children with suspected EBV infection were enrolled in this study. EBV - CA IgG antibodies and affinity, EBV- CA IgM, EBV- EA IgG, and EBNA IgG were detected by IFA. The EBV infection period and its correlation with the disease were both analyzed. Results Among 1,653 children with suspected EBV infection, 1,485 （90.0 % ） children were infected with EBV, including 301 （18.2 % ） cases of acute primary EBV infection, 423 （25.6%） cases of acute recurrent EBV infection, and 761 （46.0%） cases of past EBV in- fection. And 168 （10.0%） children were not infected with EBV. Among 724 children with acute primary EBV infection or acute recurrent EBV infection, respiratory, digestive, hematopoietic and circulatory systems were involved in EBV- related dis- eases, mainly including 238 （32.9%） cases of acute upper respiratory tract infection, 236 （32.6%） cases of acute tonsil inflam- mation, 82 （11.3%） cases of pneumonia, and 104 （14.4%） cases of fever. In children, primary EBV infection and recurrent EBV infection showed the same age distribution, and the age was less than 8 years, especially less than 4 years. Respiratory dis- eases were the main diseases caused by EBV. The types of diseases in recurrent EBV infection were more complex than those in primary EBV infection. The positive rate of EBV- CA IgM antibody in acute primary EBV infection was only 16.0 %. Con- clusion Detecting EBV antibody spectrum can comprehensively judge the phase of EBV infection and distinguish between acute EBV infection and past EBV infection, with high sensitivity and specificity and definite diagnosis. It is worth popularizing and applying.