异型淋巴细胞与EBV-DNA检测在儿童传染性单核细胞增多症中的相关分析

The correlation of atypical lymphocytes and EBV-DNA load in children with infectious mononucleosis

目的探讨异型淋巴细胞比值在EB病毒(EBV)相关儿童传染性单核细胞增多症(IM)中的变化,并分析其与EBV-DNA载量的关系。方法选取2017年1月-2018年12月广东省妇幼保健院确诊为IM的住院患儿40例为IM组,以40例EB病毒检测阴性的发热患儿为对照组。分析两组淋巴细胞总数、淋巴细胞比值及异型淋巴细胞比值的差异;分析IM组淋巴细胞总数、淋巴细胞比值、异型淋巴细胞比值与EBV-DNA载量的相关性;按EBV-DNA载量的高低分为低病毒量组和高病毒量组,分析两组各参数水平的差异。结果IM组淋巴细胞总数11.57(8.26,15.60)×10^(9)/L、淋巴细胞比值67.00%(63.60%,71.77%)、异型淋巴细胞比值15.00%(9.25%,22.75%)均显著高于对照组的2.82(1.65,4.15)×10^(9)/L、35.75%(24.05%,54.87%)和0%(0.00%,1.00%),差异均有统计学意义(P<0.01)。IM组异型淋巴细胞比值与EBV-DNA载量呈正相关(r=0.505,P<0.01),淋巴细胞总数、淋巴细胞比值与EBV-DNA载量不相关(r=0.005、-0.130,P均>0.05);高病毒量组中的异型淋巴细胞比值显著高于低病毒量组,差异有统计学意义(P<0.05)。结论EB病毒感染相关IM中异型淋巴细胞比值明显升高,且与EBV-DNA载量呈正相关,有助于儿童EB相关IM的早期筛查和诊断。

Objective To explore the change of atypical lymphocytes in epstein-barr virus(EBV)-associated infectious mononucleosis in children,and analyze the relationship of atypical lymphocytes and EBV-DNA load.Methods A total of40 cases of children patients diagnosed with IM(EBV-DNA positive)and 40 control cases of children patients with fever(EBV-DNA negative)were collected from January 2017 to December 2018 in Guangdong Women and Children Hospital.The peripheral blood total lymphocytes counts,ratio of lymphocyte and ratio of atypical lymphocyte were compared between the two groups;the correlation of total lymphocytes counts,ratio of lymphocyte and ratio of atypical lymphocyte with EBVDNA load was analyzed respectively in IM group;children were divided into low viral load group and high viral load group according to epstein-barr viral load and the differences of each parameter between the two groups were compared.Results The total lymphocytes counts 11.57(8.26,15.60)×10^(9)/L,ratio of lymphocyte 67.00%(63.60%,71.77%)and ratio of atypical lymphocyte 15.00%(9.25%,22.75%)in the IM group were significantly higher than those in the control group 2.82(1.65,4.15)×10^(9)/L,35.75%(24.05%,54.87%)and 0%(0.00%,1.00%)(P<0.05).The EBV-DNA load showed positively related with ratio of atypical lymphocyte in the IM group(r=0.505,P<0.01),but not positively related with total lymphocytes counts(r=0.005,P>0.05)and ratio of lymphocyte(r=-0.130,P>0.05).The ratio of atypical lymphocyte in the high viral load group was significantly higher than in the low viral load group(P<0.05).Conclusion The ratio of atypical lymphocyte was significant increased in IM,and was positively related with EBV-DNA load,which might be helpful in the screening and diagnose of epstein-barr virus-associated IM in children.