EB病毒致IM患儿病毒峰值载量与肝功能损害相关性分析

Correlation between peak viral load and liver function damage in children with infectious mononucleosis induced by Epstein-Barr virus

目的探讨EB病毒(EBV)致传染性单核细胞增多症(IM)患儿的EBV峰值载量与肝功能损害的关系。方法选取2018年1月至2021年12月萍乡市人民医院诊治的EBV致IM患儿80例为研究对象。抽取患儿静脉血5 mL,检测EBV-DNA峰值载量与各项肝功能指标水平,依据EBV-DNA峰值载量的高低将患儿划分成低载量组[n=25,EBV-DNA载量<104拷贝/mL]、中载量组[n=34,EBV-DNA载量104~105拷贝/mL]、高载量组[n=21,EBV-DNA载量>105拷贝/mL]。探究不同EBV-DNA峰值载量与患儿肝功能、年龄、性别之间的关系。结果高载量组肝功能异常率[85.71%(18/21)]明显高于中载量组[38.24%(13/34)]和低载量组[20.00%(5/25)],差异均有统计学意义(χ^(2)=11.90、19.71,P=0.001、<0.001);高载量组的丙氨酸氨基转移酶(ALT)[(156.24±13.21)U/L]、天门冬氨酸氨基转氨酶(AST)[(171.69±13.49)U/L]水平均高于中载量组[(125.89±10.54)U/L、(143.26±10.29)U/L]和低载量组[(89.64±6.75)U/L、(64.89±5.74)U/L],差异均有统计学意义(均P<0.001);不同年龄、不同性别组的EBV-DNA峰值载量相比,差异均无统计学意义(均P>0.05)。结论EBV致IM的患儿机体EBV-DNA峰值载量处于高表达状态,且EBV-DNA峰值载量越高,肝功能损害的发生风险越高,临床需予以高度重视,并施行及时有效的诊治措施,尽早控制患儿病情。

Objective To investigate the relationship between the peak load of Epstein-Barr virus(EPV)and live function damage in children with infectious mononucleosis caused by EPV.Methods Eighty children with infectious mononucleosis caused by EPV who received treatment in Pingxiang People's Hospital from January 2018 to December 2021 were included in this study.Five mL of venous blood was taken from each child for detecting the peak load of EBV-DNA and liver function indicators.These children were divided into a low-load group(n=25,EBV-DNA load<104 copies/mL),a medium-load group(n=34,EBV-DNA load of 104-105 copies/mL),and a high-load group(n=21,EBV-DNA load>105 copies/mL)according to the peak EBV-DNA load.The relationships between different peak loads of EBV-DNA and live function,age,and sex were analyzed.Results The rate of liver dysfunction in the high-load group[85.71%(18/21)]was significantly higher than[38.24%(13/34)]in the medium-load group and[20.00%(5/25)]in the low-load group(χ^(2)=11.90,19.71,P=0.001,P<0.001).Alanine aminotransferase and aspartate aminotransferase levels in the high-load group were(156.24±13.21)U/L and(171.69±13.49)U/L,respectively,which were significantly higher than(125.89±10.54)U/L and(143.26±10.29)U/L in the medium-load group and(89.64±6.75)U/L and(64.89±5.74)U/L]in the low-load group(all P<0.001).There was no significant difference in the peak load of EBV-DNA between children of different ages and between children of different sexes(both P>0.05).Conclusion Children with infectious mononucleosis caused by EPV have a high EBV-DNA peak load.A higher peak load of EVB-DNA indicates a higher risk of liver function damage.More attention should be paid in clinical practice.Effective diagnosis and treatment should be performed in time to control the patient's condition as early as possible.