抗体检测在婴幼儿传染性单核细胞增多症中的临床诊治分析

Analysis of Antibody Detection in Clinical Diagnosis and Treatment of Infantile Infectious Mononucleosis

目的观察EBV-DNA与EBV-IgM抗体检测在婴幼儿传染性单核细胞增多症临床诊治中的应用价值分析。方法将医院2018年5月—2020年5月收治传染性单核细胞增多症(infectious mononucleosis,IM)为诊断的患儿112例,采用EBV-DNA与EBV-IgM进行相关的抗体检测,设置为IM组。并选取同期因相同症状接受EBV-DNA与EBV-IgM进行相关的抗体检测的非IM患儿377例设置为对照组。分析其诊断的准确率,并比较患儿在接受治疗后1周、2周时的阳性率。结果IM组EBV-DNA检出率为95.54%,EBV-IgM检出率88.39%;对照组EBV-DNA检出率为3.71%,EBV-IgM检出率9.81%,差异具有统计学意义(χ^(2)=3.866、11.125,P=0.049、0.000)。EBV-DNA敏感性(95.54%)高于EBV-IgM(88.39%),EBV-DNA特异性(96.29%)高于EBV-IgM(90.19%),EBV-DNA阳性预测值(88.43%)高于EBV-IgM(72.79%),EBV-DNA阴性预测值(98.64%)高于EBV-IgM(96.32%),差异具有统计学意义(P<0.05)。1周时EBV-DNA检出率为57.14%,EBV-IgM检出率43.75%;2周时EBV-DNA检出率为9.82%,EBV-IgM检出率1.79%,差异具有统计学意义(χ^(2)=4.018、6.615,P=0.045、0.010)。结论在婴幼儿传染性单核细胞增多症患儿,采取EBV-DNA与EBV-IgM抗体检测均可获得较高的诊断准确性,相对于EBV-IgM抗体而言,以EBV-DNA抗体检测敏感性、特异性、阳性预测值与阴性预测值更高,且可以在治疗过程中,可以对治疗结果给出指导性建议。

Objective To observe the application value analysis of EBV-DNA and EBV-IgM antibody detection in the clinical diagnosis and treatment of infectious mononucleosis in infants and young children.Methods 112 children with infectious mononucleosis(IM)admitted to our hospital(from May 2018 to May 2020)were diagnosed with EBV-DNA and EBV-IgM for correlation antibody detection were set to IM group.In the same period,377 non-IM children who received EBV-DNA and EBV-IgM antibody testing for the same symptoms were selected as the control group.Analyzed the accuracy of the diagnosis,and compared the positive rates of children 1 week and 2 weeks after receiving treatment.Results The detection rate of EBV-DNA in the IM group was 95.54%,the detection rate of EBV-IgM was 88.39%;the detection rate of EBV-DNA in the control group was 3.71%,and the detection rate of EBV-IgM was 9.81%.The difference was statistically significant(χ^(2)=3.866,11.125,P=0.049,0.000).EBV-DNA sensitivity(95.54%)was higher than EBV-IgM(88.39%),EBV-DNA specificity(96.29%)was higher than EBV-IgM(90.19%),EBV-DNA positive predictive value(88.43%)was higher than EBV-IgM(72.79%),and the negative predictive value of EBV-DNA(98.64%)was higher than EBV-IgM(96.32%).The difference was statistically significant(P<0.05).At 1 week,the detection rate of EBV-DNA was 57.14%,and the detection rate of EBV-IgM was 43.75%;at 2 weeks,the detection rate of EBV-DNA was 9.82%,and the detection rate of EBV-IgM was 1.79%.The difference was statistically significant(χ^(2)=4.018,6.615,P=0.045,0.010).Conclusion In infants with infectious mononucleosis,both EBV-DNA and EBV-IgM antibody detection can obtain higher diagnostic accuracy.Compared with EBV-IgM antibody,EBV-DNA antibody detection has higher sensitivity,specificity,positive predictive value and negative predictive value,and can give guiding suggestions on treatment results during the treatment process.