中山市儿童EB病毒感染情况分析

Analysis of disease spectrum in Epstein-Barr virus infected children in Zhongshan

目的了解广东省中山市儿童EB病毒(EBV)感染情况及流行特征。方法回顾性分析2011至2013年经实时荧光定量PCR检测外周血中单个核细胞EBV-DNA的疑似EBV感染患儿的临床资料。结果 3 402例疑似EBV感染患儿中,EBV-DNA检出阳性409例,总阳性率为12.0%。其中2011年阳性率为8.1%,2012年为10.4%,2013年为19.5%,三年阳性率差异有统计学意义(P<0.05);不同性别患儿间的差异无统计学意义(P>0.05);不同年龄组间的差异有统计学意义(P<0.05),以学龄前组为最高。EBV感染性疾病以传染性单核细胞增多症为最多(61.6%),其次为呼吸道感染(26.7%)、颈淋巴结炎(3.4%)、血小板减少性紫癜(2.4%)等。在部分EBV感染患儿中,检出MP-IgM阳性79例,CP-Ig M阳性47例,细小病毒B19-IgM阳性20例,单纯疱疹病毒IgM阳性11例,巨细胞病毒IgM阳性10例,风疹病毒Ig M阳性4例。结论中山市儿童EBV-DNA阳性年检出率呈上升趋势,EBV感染后以传染性单核细胞增多症最常见,但可累及多个系统。EBV感染后可能伴有多种病原抗体阳性。

Objective To study the epidemic characteristics and disease spectrum of Epstein-Barr virus（EBV） infected children in Zhongshan region, Guangdong province. Methods Clinical data from the children with positive EBV-DNA detected by real-time fluorescent quantitative PCR between 2011 and 2013 was retrospectively analyzed. Results A total of 409 cases were detected with EBV-DNA positive from 3402 cases, with a total positive rate 12%, and the positive rate is 8.1% in 2011, 10.4% in 2012, 19.5% in 2013, there were significant differences among positive rate（χ^2=6804.00, P〈0.05）. There was no statistically significant difference in the positive rate of EBV-DNA between different gender（χ^2=0.239, P〉0.05） and different age groups（χ^2=136.96, P〈0.05）. The positive rate of pre-school group is the highest. EBV infection can cause multiple system diseases. The most common disease caused by EBV infection was infectious mononucleosis（61.6%）, followed by respiratory tract infection（26.7%）, neck lymphadenitis（3.4%）, idiopathic thrombocytopenic purpura（2.4%）, etc. Among the 409 cases of EBV infection, the concurrent other pathogen specific IgM positive cases as MP-Ig M positive（n=79）, CP-IgM positive（n=47）, Parvovirus B19-IgM positive（n=20）, HSV-IgM positive（n=11）, CMV-IgM positive（n=10）, and RV-Ig M positive（n=4） were found. Conclusions Infectious mononucleosis is the leading disease in children infected by EBV in Zhongshan region, the annual positive rate is increasing. Multiple pathogen specific IgM may be detected positive in children with EBV infection, which should be interpreted in combination with clinical status.