EB病毒多抗体联合检测在儿童EB病毒感染诊断中的应用研究

Value of joint detection of EB virus multiple antibodies in diagnosis of children with EB virus infection

目的探索EB病毒(Epstain-Barr Virus,EBV)多抗体联合检测在儿童EBV感染诊断的应用价值。方法采用Liaison化学发光分析仪定量检测2016年8月-2017年2月疑似EBV感染的4251例患儿血清中EBV(VCA-IgM、VCA-IgG、EA-IgG和NA-IgG)抗体,结合临床症状分析患儿EBV感染阶段,用PCR荧光探针法检测EBV-DNA含量。结果患儿EBV阳性1799例,阳性检出率为42.3%,其中抗体VCA-IgG阳性1769例(41.6%)、NA-IgG阳性1719例(40.4%)、VCA-IgM阳性329例(7.7%)及EA-IgG阳性136例(3.2%);四种抗体联合检测结果显示,无感染、既往感染、复发感染和原发感染比例分别为57.6%、30.7%、9.8%和1.9%;80例原发感染患儿的主要疾病为传染性单核细胞增多症(38.8%)、支气管炎及肺炎(27.5%);VCA-IgM抗体检测与EBV-DNA检测阳性率差异无统计学意义。结论通过EA-IgG、VCA-IgG、NA-IgG和VCA-IgM四种抗体联合检测,结合患儿的临床表现,可为感染EB病毒患儿早发现、早诊断、早治疗提供依据,值得推广应用。

OBJECTIVE To explore the value of joint detection of Epstain-Barr Virus（EBV）multiple antibodies I n diagnosis of children with EBV infection.METHODS From Aug 2016 to Feb 2017,the serum EBV antibodies（VCA-IgM,VCA-IgG,EA-IgG,NA-IgG）of 4251 children with suspected EBV infection were detected by using Liaison chemiluminescence analyzer.The stages of EBV infection were analyzed according to clinical symptoms,and the EBV-DNA content was determined by means of PCR fluorescence probe.RESULTS Totally 1799 children showed positive for EBV,with the positive rate 42.3%,1769（41.6%）of whom were positive for VCA-IgG,1719（40.4%）were positive for NA-IgG,329（7.7%）were positive for VCA-IgM,and 136（3.2%）were positive for EA-IgG.The result of the joint detection of four antibodies indicated that the children without infection accounted for 57.6%,the children with previous infection 30.7%,the children with recurrent infection 9.8%,the children with primary infection 1.9%.Of the 80 children with primary infection,38.8% had infectious mononucleosis,and27.5% had bronchitis and pneumonia.There was no significant difference in the positive rate between the VCAIgM detection and the EBV-DNA detection.CONCLUSION The joint detection of the four types of antibodies,in cluding EA-IgG,VCA-IgG,NA-IgG and VCA-IgM,in combination with clinical manifestations,may provide bases for early detection,diagnosis and treatment of the children with EBV infection,and it is worthy to be promoted.