黑龙江省儿童EB病毒的感染情况及疾病谱分析

Analysis of the EBV Infection and Disease Spectrum of Children in Heilongjiang Province

目的:研究EB病毒(Epstein-barr virus,EBV)感染的儿童外周血单个核细胞(PBMC)中的EBV-DNA水平与疾病谱的相关性,进一步了解黑龙江省儿童EBV感染情况及流行特征。方法:选择2015年6月至2016年2月就诊于哈尔滨医科大学附属第二医院儿内科门诊疑似EBV感染收入院的患儿,用荧光定量PCR法检测外周血PBMC中的EBV-DNA含量,并收集相应临床资料。用χ2检验和秩和检验分析不同疾病中EBV-DNA水平的差异和不同EBV-DNA水平疾病谱的分布情况。结果:762例儿童中,EBV-DNA检测阳性329例,检出率为43.1%。在EBV-DNA阳性的患儿中,男性患儿198例,女性患儿131例,不同性别的阳性检出率比较无统计学差异(P=0.182);不同年龄的患儿EBV-DNA检出率的差异有统计学意义(P=0.000),学龄前组最高,婴儿组最低;EBV-DNA定量值虽然有学龄前组>学龄组>幼儿组>婴儿组的趋势,但是无统计学差异(P=0.337);主要疾病谱所占比例从高到低依次为:呼吸系统疾病、IM、脑炎、单纯EBV感染和血液系统疾病,其中呼吸系统疾病最多40例(42.6%);IM的EBV-DNA含量最高1.522e+004(6.55e+001-4.602e+006),并且与其他各组比较均有统计学差异(P=0.000),其余各组之间无统计学差异。EBV-DNA水平不同相关疾病谱亦有差异(P=0.00),同一EBV-DNA水平中每种疾病大于10%病例数分布在(1.00-9.99)e+001-(1.00-9.99)e+006,IM最高主要分布在(1.00-9.99)e+004-(1.00-9.99)e+006之间,其余疾病主要分布在(1.00-9.99)e+001-(1.00-9.99)e+005。结论:黑龙江地区儿童EBV感染率处于较高的水平,EBV-DNA水平高低与疾病谱密切相关。

Objective： To study the correlation between the EB virus（Epstein-barr virus, EBV）DNA levels in peripheral blood mononuclear cell（PBMC） of the children with EBV infection and disease spectrum and learn more about the situation of EBV infected children and the epidemiological characteristics in Heilongjiang province. Methods： Cases WEre collected in the pediatric department of internal medicine in the second affiliated hospital of Harbin medical university from June 2015 to February 2016, corresponding clinical datas also collected. The results were analyzed using the chi-square test and rank test. Results： Fluorescence quantitative PCR analysis revealed EBV DNA was detected in 43.1%（329/762）children patients. Among the children with EBV-DNA positive there is no statistical differences of the gender（P=0.182）; Difference of the positive rate of EBV-DNA of the children with different ages was statistically significant（P = 0.000）, the preschool group is highest and the infant group is lowest, but there is no statistical difference（P=0.337）with the trend; The largest proportion of main disease spectrum was respiratory system disease,it up to 40 cases（42.6%）; IM had the highest levels of EBV-DNA, up to 1.522e＋004（6.55e＋001-4.602e＋006）, and were statistically significantly with other groups（P=0.000）, but there is no statistical difference between those groups. There is a statistical difference between the levels of EBV-DNA and disease spectrum as well（p=0.000）, And each kind of these diseases in the same levels of EBV-DNA with more than 10% cases were distributed in the range from（1.00-9.99）e＋001 to（1.00-9.99）e＋006, the highest distribute range of IM mainly from the（1.00-9.99）e＋004 to（1.00-9.99）e＋006, others were mainly distributed in the range from（1.00-9.99）e＋001 to（1.00-9.99）e＋005. Conclusion： Our study revealed that there is a higher level of EBV infection rate of the children in Heilongjiang province, and there is a closely relationship between the EBV DNA level and the disease spectrum.