VCA-IgM与EB-DNA对儿童传染性单核细胞增多症的诊断效能

Diagnostic efficacy of VCA-IgM in combination with EB-DNA for diagnosis of infectious mononucleosis in children

目的探讨衣壳抗原免疫球蛋白M抗体(VCA-IgM)、人类疱疹病毒第四型(EB)病毒脱氧核糖核酸(EB-DNA)对儿童传染性单核细胞增多症的诊断效能。方法回顾性收集2019年6月-2022年6月安徽医科大学附属安庆第一人民医院收治的82例传染性单核细胞增多症患儿临床资料作为研究组,选取同期于医院体检的89名健康体检儿童体检资料作为对照组,统计两组临床资料及VCA-IgM阳性率、EB-DNA载量,比较传染性单核细胞增多症患儿不同病理分期VCA-IgM阳性率、EB-DNA载量及不同年龄段传染性单核细胞增多症患儿患病特点,采用受试者工作特征(ROC)曲线评估VCA-IgM、EB-DNA单独和联合检测对传染性单核细胞增多症的诊断效能。结果研究组VCA-IgM阳性率、EB-DNA载量均高于对照组(P<0.05);前期、中期、后期、末期传染性单核细胞增多症患儿EB-DNA载量呈逐渐升高趋势,不同组间比较,差异有统计学意义(P<0.05);VCA-IgM、EB-DNA联合检测曲线下面积(AUC)(0.919)和特异度(96.63%)高于两者单独诊断(P<0.05);>6岁单核细胞增多症患儿肝损伤发生率高于3~6岁患儿,<3岁患儿心肌损伤发生率高于3~6岁、>6岁患儿(P<0.05)。结论VCA-IgM、EB-DNA对儿童传染性单核细胞增多症具有较好的诊断效能,两者联合可进一步提高诊断效能,不同年龄段传染性单核细胞增多症患儿肝损伤和心肌损伤存在较明显的差异。

OBJECTIVE To investigate the combined diagnostic efficacy of the capsid antigen immunoglobulin M antibody(VCA-IgM)and Epstein-Barr(EB)virus deoxyribonucleic acid(EB-DNA)for the diagnosis of infectious mononucleosis in children.METHODS The clinical data of 82 children with infectious mononucleosis admitted to the Anqing First people's Hospital affiliated to Anhui Medical University from Jun.2019 to Jun.2022 were retrospectively collected as the study group,and the physical examination data of 89 children underwent healthy examination in our hospital during the same period were selected as the control group.The general information,VCA-IgM positive rate and EB-DNA load of the two groups were analyzed.The positive rate of VCA-IgM and EB-DNA load of children with infectious mononucleosis at different pathological stages,and the disease characteristics of children with infectious mononucleosis at different ages were compared.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of VCA-IgM and EB-DNA alone and in combination for the diagnosis of infectious mononucleosis.RESULTS The positive rate of VCA-IgM and EB-DNA load in the study group were higher than those in the control group(P<0.05).The EB-DNA load of children with infectious mononucleosis in the early,middle,late and late stages increased gradually,and the difference between different groups was statistically significant(P<0.05).The area under curve(AUC)(0.919)and specificity(96.63%)of the combined VCA-IgM and EB-DNA were higher than both diagnosed separately(P<0.05).The incidence of liver injury in children aged 6 years with mononucleosis was higher than that in children aged 3~6 years,and the incidence of myocardial injury in children 3 years old was higher than that in children 3~6 years old and 6 years old(P<0.05).CONCLUSION VCA-IgM and EB-DNA had good diagnostic efficacy for children with infectious mononucleosis,and their combination could further improve the diagnostic efficacy.There were significant differences in liver injury and myocardial injury in children with infectious mononucleosis at different ages.