患儿呼吸道感染EB病毒外周血淋巴细胞及异型淋巴细胞比值变化的临床研究

Clinical study on the changes of peripheral blood lymphocyte and atypical lymphocyte in children with respiratory tract infection infected by EB virus

目的本研究旨在阐明儿童呼吸道感染EB病毒(EBV)外周血淋巴细胞、异型淋巴细胞比值变化,及其与EBV-DNA载量的相关性。方法选择2015年3月-2016年6月医院确诊为呼吸道感染的住院患儿624例,另选择同期健康儿童100名作为对照组,采用实时荧光定量PCR检测其外周血EBV-DNA载量;利用全血细胞分析仪进行血常规检测,统计分析淋巴细胞检测结果;同时人工镜检外周血异型淋巴细胞并计算百分比。结果健康对照组儿童外周血未检出EBV-DNA,624例呼吸道感染患儿共检出EBV-DNA阳性245例,阳性率为39.26%,EBV-DNA阳性样本平均EBV-DNA病毒载量为(3.56±0.68)log IU/ml;1~3岁组患儿EBV-DNA阳性率高于<1岁及>3岁患儿,不同年龄呼吸道感染患儿EBV-DNA检测阳性率比较,差异有统计学意义(P<0.05);呼吸道感染EBV-DNA阳性组患儿外周血淋巴细胞及异型淋巴细胞比值,均高于呼吸道感染EBV-DNA阴性组患儿及健康对照组,差异均有统计学意义(P<0.001)。结论呼吸道感染EBV患儿外周血淋巴细胞及异型淋巴细胞比值明显升高,并与EBV-DNA载量呈正相关,可作为初步快速诊断呼吸道感染EBV的辅助性检测指标,适用于广大的基层医院。

OBJECTIVE To analyze the changes of peripheral blood lymphocyte and atypical lymphocyte in children with respiratory tract infection infected by EB virus（EBV）, and their correlation with EBV-DNA load. METHODS A total of 624 cases of children patients diagnosed with respiratory tract infection and 100 health control cases were collected from Mar. 2015 to Jun. 2016 in Chenzhou First People＇s Hospital. EB-DNA load in peripheral blood was detected by real-time fluorescence quantitative PCR, and the whole blood cell analyzer was used for routine blood test and the resuhs of lymphocyte test were analyzed statistically. At the same time, peripheral blood atypical lymphocytes were artificially examined and the percentage was calculated. RESULTS None EBV-DNA was detected in control group, and the positive rate of EBV-DNA in respiratory tract infection group was 39. 26% （245/624）. The average EBV-DNA viral load of EBV-DNA positive samples was （3. 56±0. 68）1og IU/ml. The EBV-DNA positive rate of children of 1-3 years old was higher than that of 〈1 year old and〉 3 years old, and the positive rate of EBV-DNA in children with respiratory tract infection with different ages was significant （P〈0.05）. The percentages of lymphocyte and lymphocyte in the EBV-DNA positive group of children with respiratory tract infection were significantly higher than those in the EBV-DNA negative group and control group （P 〈 0. 001）. CONCLUSION The percentages of lymphocyte and atypical lymphocytes were increased in children patients with respiratory tract infection infected by EBV, and positively related to EBV load, which can be regarded as an early assistant diagnostic indicator of respiratory tract infection with EBV and can also be applied to the basic level hospitals.