间接免疫荧光法检测儿童EB病毒抗体的临床价值

Clinical value of indirect immunofluorescence assay in detectiing EBV antibody in Children

目的探讨间接免疫荧光法检测EB病毒抗体在儿童EB病毒感染中的临床价值。方法应用间接免疫荧光法检测1166例疑似EB病毒感染的患儿血中的EBV-CA Ig G抗体及亲和力、EBV-CA Ig M、EBV-EA Ig G、EBNA。结果 1 166例疑似EB病毒感染的患儿中,发生EBV感染的病例数为1133例(97.17%),无EBV感染33例(2.83%)。1133例EBV感染患儿涉及的相关疾病包括呼吸、消化、血液等多个系统,主要包括上呼吸道感染263例(23.21%),扁桃体炎160例(14.12%),肺炎149例(13.15%),发热待查149例(13.15%),支气管炎132例(11.65%),紫癜107例(9.44%);EBV感染患儿分为原发感染组(10.47%)、既往感染组(81.13%)、复发感染组(2.57%)和极少见血清组(3%),原发感染组中以EBV-CA Ig M阴性、EBV-CA Ig G阳性、EBV-EA Ig G阳性或阴性、EBNA阴性、EBV-CA Ig G低亲合力的反应模式最常见,共83例(7.12%),既往感染组中以EBV-CA Ig M阴性、EBV-CA Ig G阳性、EBV-EA Ig G阳性或阴性、EBNA阳性、EBV-CA Ig G高亲合力的反应模式最常见,共823例(70.58%)。结论 EBV抗体谱检测在EBV感染相关疾病诊断中很有价值,能更准确地判断EBV的感染分期,有助于临床的诊断和治疗。

Objective To evaluate the clinical value of indirect immunofluorescence assay （IFA） in detecting EBV antibody in children infected with Epstein- Ban virus （EBV）. Methods The IFA was used to detect EBV-CA IgG antibody and affinity, EBV-CA IgM, EBV-EA IgG and EBNA IgG of a total of 1166 children with suspected EBV infection.Resnits Among the 1166 children with suspected EBV infection, 1133 （97.17%） children were infected with EBV and 33（2.83%） children were not infected with EBV. Among the 1133 children infected with EBV, respiratory/digestive/hematopoietic and other systems were involved inEBV- related disease, which including 263 （23.21%） cases of upper respiratory tract infection, 160（ 14.12% ） cases of tonsillitis, 149 （ 13.15% ） cases of pneumonia, 149 （ 13.15% ） cases of unknown fever, 132 （11.65%） cases of bronchitis and 107 （9.44%） cases of purpura. EBV-infected children were divided into primary infection group （ 10.47% ）, previous infection group （ 81.13% ）, recurrent infection group （ 2.57% ） and uninfected group （ 3% ）. In primary infection group, the response pattern of EBV-CA IgG positive, EBV-EA IgG positive or negative, EBNA negative and low avidity EBV-CA IgG was the most common, and with 83 （7.12%）cases in total. In the previous infection group, the response pattern of EBV-CA IgM negative, EBV-CA IgG positive, EBV-EA IgG positive or negative, EBNA positive and high avidity EBV-CA IgG was the most common, totally 823（ 70.58% ） cases.Conclnsions EBV antibody detection is valuable in the diagnosis of EBV infection and it can be used to judge the infection stage of EBV more accurately, which is helpful for clinical diagnosis and treatment.