不同年龄儿童EB病毒感染状况分析

Analysis of Epstein-Barr viral infection status in different ages of children

目的分析儿童EB病毒感染在不同年龄引起的临床疾病差异。方法选取2016年1-7月中山大学附属第一医院收治的检测EB病毒儿童469例作为研究对象,根据儿童年龄分为婴幼儿期组(0~<1岁,147例)、幼儿期组(1~3岁,96例)、学龄前组(3<7岁,102例)和学龄期组(7~12岁,124例)。采用实时荧光定量聚合酶链反应方法检测469例儿童淋巴细胞EB病毒DNA,分析不同年龄组儿童EB病毒在临床疾病中的感染状况。结果469例儿童中EB病毒检测阳性227例,阳性率为48.4%。婴幼儿期组儿童中EB病毒检测阳性67例,主要临床疾病为肝移植术后[89.6%(60/67)];幼儿期组儿童中EB病毒检测阳性42例,主要临床疾病为肝移植术后[40.5%(17/42)]和支气管肺炎[28.6%(12/42)];学龄前组儿童中EB病毒检测阳性43例,主要临床疾病为肾病综合征[30.2%(13/43)]和化脓性扁桃体炎[18.6%(8/43)];学龄期组儿童中EB病毒检测阳性75例,主要临床疾病为肾病综合征[29.3%(22/75)]和系统性红斑狼疮[28.0%(21/75)]。此外,不同年龄组儿童EB病毒感染者肝移植术后、传染性单核细胞综合征、化脓性扁桃体炎、肾病综合征、系统性红斑狼疮患病率比较,差异均有统计学意义(P<0.05)。结论EB病毒是儿童感染重要的病原体,临床疾病多样,累及多系统。加强儿童EB病毒的监测可为临床及早抗感染治疗和预防提供科学依据。

Objective To analyze the differences of Epstein-Barr(EB)virus infection caused clinical diseases in different ages of children.Methods A total of 469 children patients with detected EB virus infection in the First Affiliated Hospital of SUN Yat-sen University from January to July 2016 were selected as the study subjects and were grouped as the infants and young children group(0-<1 years old,n=147),young children group(1-3 years old,n=96),preschool group(3-7 years old,n=102)and school-age group(7-12 years old,n=124).The EB viraus DNA in lymphocytes was detected by adopting the real-time fluorescence quantitative PCR(q-PCR).The infection status of EB virus in clinical diseases among different ages of children was analyzed.Results Among 469 children,227 cases of EB virus positive were detected with a positive rate of 48.4%.In the infants and young children group,67 cases of EB virus positive were detected,and the main clinical disease was post liver transplantation[89.6%(60/67)];in the young children group,42 cases of EB virus positive were detected,and the main clinical diseases were post liver transplantation[40.5%(17/42)]and bronchial pneumonia[28.6%(12/42)];in the preschool group,43 cases of EB virus positive were detected,and main clinical diseases were nephrotic syndrome[30.2%(13/43)and suppurative tonsillitis[18.6%(8/43)];in the school group,75 cases of EB virus positive were detected,and main clinical diseases were nephrotic syndrome[29.3%(22/75)]and systemic lupus erythematosus[28.0%(21/75)].In addition,the incidence rates of post liver transplantation,infectious mononucleosis syndrome,purulent tonsillitis,nephrotic syndrome and systemic lupus erythematosus had statistical difference among different ages groups(P<0.05).Conclusion EB virus is an important pathogen of childhood infection.The clinical diseases are diversity and multiple systems are involved.Strengthening children EB virus monitoring can provide the scientific basis for the clinical anti-infection treatment and prevention as early as possible.