对比分析EB病毒实验室检测方法的应用价值

Comparative analysis of application value of EB virus laboratory detection method

目的:对比分析EB病毒(EBV)多抗体联合检测EBV-DNA定量分析及外周血白细胞检测的应用价值。方法:回顾性分析2017-06—2018-12收治的749例疑似患者实验室检查结果,根据EBV-DNA含量的不同将标本分成A^E 5组进行比较分析:495例EBV-DNA含量<5×10^2IU/ml的血清标本为A组;57例EBV-DNA含量5×10^2IU/ml^5×10^3IU/ml的血清标本为B组;127例EBV-DNA含量5×10^3IU/ml^5×10^4IU/ml的血清标本为C组;48例EBV-DNA含量5×10^4IU/ml^5×10^5IU/ml的血清标本为D组;22例EBV-DNA含量>5×10^5IU/ml的血清标本为E组。用化学发光法检测血清中EBV早期抗原IgG抗体(EA-IgG)、EBV衣壳抗原IgM抗体(VCA-IgM)、EBV衣壳抗原IgG抗体(VCA-IgG)、EBV核抗原IgG抗体(NA-IgG);用荧光定量PCR法检测外周血EBV-DNA;全血细胞仪进行血常规检测。结果:①A组中EA-IgG、VCA-IgM、VCA-IgG、NA-IgG的阳性率分别为9.70%,21.82%,33.94%,38.59%;白细胞计数(WBC)、淋巴细胞绝对值(LYM)、中性粒细胞绝对值、单核细胞绝对值(MONO)的阳性率分别为21.01%,46.26%,15.76%,58.18%,经t检验比较,VCA-IgG和NA-IgG的检出率明显高于EA-IgG和VCA-IgM(P<0.05),LYM和MONO的阳性率明显高于WBC和中性粒细胞绝对值(P<0.05);②B、C、D、E组中EA-IgG、VCA-IgM、VCA-IgG、NA-IgG的阳性率分别依次为31.58%,43.31%,64.58%,59.09%;21.05%,35.43%,58.33%,81.82%;89.47%,98.43%,91.67%,86.36%;85.96%,87.40%,75.00%,45.45%。WBC、LYM、中性粒细胞绝对值、MONO的阳性率分别依次为12.28%,26.77%,33.33%,54.55%;31.58%,41.73%,56.25%,81.82%;12.28%,15.75%,8.33%,9.09%;42.11%,60.63%,66.67%,72.73%;VCA-IgM、WBC、LYM及MONO的阳性率随着EBV-DNA含量的增加而增大(P<0.05);③A、B及C组中均以EA-IgG(-)、VCA-IgM(-)、VCA-IgG(+)、NA-IgG(+)最多见,D组中以4种抗体均为阳性最多见,E组中以EA-IgG(+)、VCA-IgM(+)、VCA-IgG(+)、NA-IgG(-)最多见。结论:联合检测EBV抗体、血液分析及EBV-DNA有助于提高EBV感染的诊断和防治。

Objective:To compare and analyze the application value of combined detection of Epstein-Barr virus multi-antibody,EBV-DNA quantitative analysis and peripheral blood leukocyte detection. Method:The results of laboratory examinations of 749 patients admitted to our hospital from June 2017 to December 2018 were retrospectively analyze.These patients were divided into groups A,B,C,D and E according to the difference of EBV-DNA content for comparative analysis:495 serum samples with EBV-DNA content<5×10^2IU/ml were group A,57 serum samples with EBV-DNA content of 5×10^2-5×10^3 were group B;127 serum samples with EBV-DNA content of 5×10^3-5×10^4 were group C;48 cases of EBV-DNA content serum samples of 5×10^4-5×10^5 were group D;and 22 serum samples with EBV-DNA content>5×10^5 were group E.EB V early antigen IgG antibody(EA-IgG),EBV capsid antigen IgM(VCA-IgM),EBV capsid antigen IgG(VCA-IgG)and EBV nuclear antigen IgG(NA-IgG)were detected by chemiluminescence method;peripheral blood EBV-DNA was detected by real-time PCR;blood routine detection was performed by whole blood analyzer. Result:①In group A,the positive rates of EA-IgG,VCA-IgM,VCA-IgG and NA-IgG were 9.70%,21.82%,33.94% and 38.59%,respectively;The positive rates of white blood cell count(WBC),absolute lymphocyte count(LYM),neutral granulocyte absolute value and absolute value of monocyte(MONO) were 21.01%,46.26%,15.76%,and 58.18%,respectively.The detection rates of VCA-IgG and NA-IgG were significantly higher than those of EA-IgG and VCA-IgM(P<0.05),the positive rates of LYM and MONO were significantly higher than those of WBC and absolute neutrophil count(P<0.05);②In group B,C,D and E,the positive rates of EA-IgG,VCA-IgM,VCA-IgG and NA-IgG were 31.58%,43.31%,64.58% and 59.09%;21.05%,35.43%,58.33% and 81.82%;89.47%,98.43%,91.67% and 86.36%;85.96%,87.40%,75.00% and 45.45%,respectively.The positive rates of WBC,LYM,absolute neutrophil count and MONO were 12.28%,26.77%,33.33% and 54.55%;31.58%,41.73%,56.25% and 81.82%;12.28%,15.75%,8.33% and 9.09%;42.11%,60.63%,66.67% and 72.73%,respectively;The positive probability of VCA-IgM,WBC,LYM and MONO increased with the increase of EBV-DNA content(P<0.05);③In groups A,B and C,EA-IgG(-),VCA-IgM(-),VCA-IgG(+)and NA-IgG(+)were the most common.In group D,the positive combination pattern of all four antibodies was the most common.In group E,EA-IgG(+),VCA-IgM(+),VCA-IgG(+)and NA-IgG(-)were most common.Conclusion:Combined detection of EBV antibody,blood analysis and EBV-DNA could help improving the diagnosis and prevention of EBV infection.