外周血异型淋巴细胞检查与EBV DNA定量检测在IM的早期诊断价值

目的探讨外周血异型淋巴细胞检查与EBV DNA定量检测在传染性单核细胞增多症（IM）的早期诊断及病情评估价值。方法选取2014年9月至2017年9月确诊为IM的患儿91例为观察组，健康体检儿童100例为对照组。抽取观察组患儿抗凝外周血做血涂片异型淋巴细胞检查及应用实时荧光定量PCR技术检测EBV DNA定量，异型淋巴细胞〉10％及EBV DNA定量结果〉1．0×10^3 copy为阳性，比较观察组患儿两种方法阳性率的差异；比较观察组与对照组儿童肝功能检查（ALT）、心肌酶谱（AST、CKMB、HBD、LDH）、WBC计数、LY％等指标的差异；根据异型淋巴比例及EBV DNA定量检测结果分为高、低值组，分析高／低值组在肝功能检查、心肌酶四项、WBC计数、LY％等指标的差异。结果观察组患儿外周血异型淋巴细胞检查与EBvDNA检测的阳性率差异无统计学意义（P〉0．05）；观察组与对照组儿童在肝功能检查（ALT）、心肌酶四项（AST、CKMB、HBD、LDH）、WBC计数、LY％比较，差异有统计学意义（P〈0．05）；在IM患者中，异型淋巴细胞高、低值组比较，仅KWBC计数、LY％差异有统计学意义（P〈0．05）；EBV DNA定量检测高、低值组肝功能检查、心肌酶四项、WBC计数、LY％比较，差异均无统计学意义（P〉0．05）。结论外周血异型淋巴细胞和EBV DNA定量检测在IM早期诊断中具有重要意义，而异型淋巴比例及EBV DNA定量结果不能作为临床病情评估指标。

Objective To explore the application of peripheral blood smear-atypical lymphocyte detection and EBV DNA quantitative test in the diagnosis and clinical indicators of infectious mononucleosis. Methods A total of 91 patients who were diagnosed with infectious mononucleosis from September 2014 to September 2017 in Huizhou First People＇s Hospital were selected as the study group. The normal group consisted of 100 healthy subjects. The anticoagulation peripheral blood of 91 patients were extracted for atypical lymphocyte detection and EBV DNA quantitative detection, results were positive when atypical lymphocyte〉 10% or EBV DNA quantitative detection〉 1.0 × 10^3copy. First, 91 cases of patients were used to detect the difference of the positive rate between the two groups by using the method of atypical lymphocyte detection and EBV DNA quantitative detection. Then, the liver function test （ALT） , the cardiac function test （AST, CKMB, HBD, LDH ） , WBC count, LY% were statistically analyzed between the diseases group and the normal group finally, the atypical lymphocyte and the EBV DNA quantitative detection results were divided into high / low value group, the liver function test （ALT） , the cardiac function test （AST, CKMB, HBD, LDH） , WBC count, LY% were statistically analyzed. Results There was no significant difference between the two groups in the atypical lymphocyte and EBV DNA quantitative detection （ P〉0.05 ） .The liver function test （ ALT ） , the cardiac function test （ AST, CKMB, HBD, LDH ） , WBC count, LY% were statistically different （P〈0.05） between the diseases group and the normal group . In the high / low value group of atypical lymphocyte, the difference in WBC count and LY% was statistically different （P〈0.05） . In the high and low value group of EBV DNA quantitative detection, there were no significant differences between the liver function test （ALT） , the cardiac function test （AST, CKMB, HBD, LDH） , WBC count, LY% （P〉0.05） . Conclusion The atypical lymphocyte and EBV DNA quantitative detections in peripheral blood are very important in the early diagnosis of infection cannot be used as clinical indicators for the disease.