孝感地区传染性单核细胞增多症患儿EBV抗体、DNA检测结果及社区居民流行病学分析

EBV antibody and DNA test results of children with infectious mononucleosis in Xiaogan area and epidemiological analysis of community residents

目的分析孝感地区传染性单核细胞增多症(IM)患儿EB病毒(EBV)抗体及DNA检测结果,并分析该地区社区居民EBV抗体携带的流行病学特点。方法选取2016年12月至2020年12月在该院住院的IM患儿120例为病例组,选取同期于该院体检的儿童124例为对照组。从该院体检者中选取具备EBV抗体及DNA检测结果的1522例孝感地区社区居民作为流行病学调查对象。用酶联免疫吸附试验检测EBV抗体,采用实时荧光定量PCR检测血浆及外周血单个核细胞(PBMC)中EBV DNA水平。结果病例组EBV DNA、衣壳抗原(VCA)IgA、VCA IgM、核抗原(NA)IgA、早期抗原(EA)IgA阳性率均高于对照组,VCA IgG、NA IgG阳性率均低于对照组,差异有统计学意义(P<0.05)。各年龄段社区居民VCA IgA、NA IgA、EA IgA阳性率均较低,NA IgG和VCA IgG在≥1岁居民中阳性率随着年龄增长有逐渐增高趋势,在≥60岁居民中NA IgG、VCA IgG阳性率均达100%。120例IM患儿中,有72例患儿同时采集PBMC及血浆标本进行了EBV DNA检测,其中PBMC标本检出EBV DNA阳性69例,阳性率为95.83%(69/72),血浆标本检出EBV DNA阳性59例,阳性率为81.94%(59/72),PBMC标本EBV DNA阳性率高于血浆标本,差异有统计学意义(P<0.05)。结论孝感地区IM患儿EBV的VCA IgM、VCA IgA、NA IgA和EA IgA阳性率较高,而VCA IgG和NA IgG阳性率降低。社区居民EBV既往感染普遍存在,且年龄越大,既往感染率越高。血浆标本检出的EBV DNA阳性率较低。

Objective To analyze the EB virus(EBV)antibody and DNA test results of infectious mononucleosis(IM)children in Xiaogan area,and analyze the epidemiological characteristics of EBV antibody carried by community residents in this area.Methods A total of 120 children with IM who were hospitalized in this hospital from December 2016 to December 2020 were selected as the case group,and 124 children who underwent physical examination in the hospital during the same period were selected as the control group.A total of 1522 residents in Xiaogan area with EBV antibody and DNA test results who underwent physical examination in the hospital were selected as the epidemiological investigation objects.EBV antibodies were detected by enzyme-linked immunosorbent assay,and EBV DNA levels in plasma and peripheral blood mononuclear cell(PBMC)were detected by real-time fluorescence quantitative PCR.Results The positive rates of EBV DNA,capsid antigen(VCA)IgA,VCA IgM,nuclear antigen(NA)IgA,and early antigen(EA)IgA in the case group were higher than those in the control group,while the positive rates of VCA IgG and NA IgG were lower than those in the control group,and the differences were statistically significant(P<0.05).The positive rates of VCA IgA,NA IgA and EA IgA in community residents of all age groups were all low.The positive rates of NA IgG and VCA IgG in residents aged≥1 tended to increase with age,and the positive rates of NA IgG、VCA IgG among residents aged≥60 were all up to 100%.Among the 120 children with IM,72 children were simultaneously collected PBMC and plasma samples for EBV DNA detection.Among them,69 cases were positive for EBV DNA in PBMC samples,with a positive rate of 95.83%(69/72),and 59 cases were detected in plasma samples with positive EBV DNA,with a positive rate of 81.94%(59/72),the positive rate of EBV DNA in PBMC samples was higher than that in plasma samples,and the difference was statistically significant(P<0.05).Conclusion In Xiaogan area,the positive rates of EBV VCA IgM,VCA IgA,NA IgA and EA IgA in children with IM increased,while the positive rates of VCA IgG and NA IgG decreased.EBV previous infection in community residents is prevalent,and the older the age,the higher the previous infection rate.The positive rate of EBV DNA detected in plasma samples is low.