EB病毒核酸测定在儿童EB病毒感染中的应用价值

Application value of nucleic acid detection of Epstein-Barr virus in children infected by Epstein-Barr virus

目的探讨Epstein-Barr病毒(EB病毒)核酸(DNA)测定在儿童EB病毒感染中的应用价值。方法临床纳入可疑EB病毒感染患儿、传染性单核细胞增多症(IM)患儿以及健康儿童3组。采用荧光定量聚合酶链反应(FQ-PCR)EB病毒DNA扩增办法对3组儿童的EB病毒DNA及载量进行检测。结果可疑EB病毒感染患儿中,EB病毒DNA阳性率(病毒载量≥500拷贝/ml)为24.08%(124/515),IM患儿阳性率为74.67%(56/75),健康儿童阳性率为5.00%(1/20),3组EB病毒DNA阳性率比较差异均统计学意义(χ~2=79.027,P<0.05)。EB病毒DNA阳性载量最高为4.56×10~6拷贝/ml,最低为4.31×10~2拷贝/ml。阳性疾病主要诊断以支气管炎、肺炎以及病毒性脑炎多见,分别占21.77%、22.58%、16.94%;阳性疾病次要诊断以心肌损伤、合并支原体感染以及贫血多见,分别占50.81%、36.29%、33.06%。健康组儿童1、2、3、4周EB病毒DNA载量分别为(0.4±0.09)、(0.37±0.08)、(0.42±0.10)、(0.38±0.09)×10~3拷贝/ml;可疑EB病毒感染患儿1、2、3、4周EB病毒DNA载量分别为(4.2±1.3)、(5.3±1.2)、(4.1±1.4)、(3.9±1.2)×10~4拷贝/ml;IM患儿1、2、3、4周EB病毒DNA载量分别为(5.5±1.2)、(6.3±1.3)、(4.9±1.5)、(4.4±1.2)×10~4拷贝/ml。3组患儿各周EB病毒DNA载量差异均有统计学意义(F=73.06、104.30、129.55、158.62,均P<0.05)。结论 EB病毒DNA检测有助于诊断儿童EB病毒感染,并提示相关疾病。

Objective To explore the clinical application value of nucleic acid（ DNA） detection of Epstein-Barr（ EB） virus in children infected by EB virus. Methods The children suspected of EB virus infection,the children with infectious mononucleosis（ IM）,and healthy children were enrolled in this study. Fluorescence quantitative polymerase chain reaction（ FQ-PCR） for amplification of EB virus DNA was adopted to detect DNA and load of EB virus in the three groups. Results The positive rates of EB virus DNA（ viral load ≥500 copies/ml） in children suspected of EB virus infection,IM children,and healthy children were 24. 08%（ 124/515）,74. 67%（ 56/75）,and 5. 00%（ 1/20）,respectively,there were statistically significant differences among these three groups（ χ~2= 79. 027,P〈0. 05）.EB virus load ranged from 4. 56×10~6copies/ml to 4. 31×10~2copies/ml. Among the children with EB virus infection,the main diseases were bronchitis,pneumonia,and viral encephalitis,accounting for 21. 77%,22. 58%,and 16. 93%,respectively; the secondary diagnosis in these children were myocardial injury,mycoplasma infection,and anemia,accounting for 50. 81%,36. 29%,and 33. 06%,respectively.DNA loads of EB virus in healthy children were（ 0. 4±0. 09）,（ 0. 37±0. 08）,（ 0. 42±0. 10）,and（ 0. 38±0. 09） ×10~3copies/ml in 1,2,3,and 4 weeks,respectively. DNA loads of EB virus among the children suspected of EB virus infection were（ 4. 2± 1. 3）,（ 5. 3± 1. 2）,（ 4. 1±1. 4）,and（ 3. 9±1. 2） ×10^4opies/ml in 1,2,3,and 4 weeks respectively. DNA loads of EB virus among IM children were（ 5. 5±1. 2）,（ 6. 3±1. 3）,（ 4. 9±1. 5）,and（ 4. 4±1. 2） ×10^4opies/ml in 1,2,3,and 4 weeks respectively. There were statistically significant differences in DNA loads of EB virus among the three groups in 1,2,3,and 4 weeks（ F = 73. 06,104. 30,129. 55,158. 62,all P〈0. 05）.Conclusion DNA detection of EB virus is conducive to diagnosis of EB virus infection in children,which can indicate the associated diseases.