儿童EB病毒DNA与肺炎的相关因素分析

Analysis of the correlation factors between EB virus DNA and pneumonia in children

目的:探讨儿童EB病毒(Epstein-Barr virus,EBV)DNA与肺炎的相关因素,提高临床医师对EBV感染儿童诊疗的认识。方法:回顾性选择2021年5月—2023年4月惠州市中心人民医院和惠州市第一妇幼保健院住院的EBV-DNA阳性患儿612例,收集同期住院的EBV-DNA阴性患儿1178例为对照组。根据有无合并肺炎将EBV-DNA阳性患儿分为肺炎组(n=242)及非肺炎组(n=347),采用logistic回归分析探讨儿童EBV-DNA阳性合并肺炎的相关因素。结果:612例EBV-DNA阳性患儿中,男女比例为1.35∶1,发病年龄3个月~13岁,婴儿期21例(3.4%)、幼儿期136例(22.2%)、学龄前期319例(52.1%)、学龄期136例(22.2%),患者高峰年龄为学龄前期。EBV-DNA阳性合并肺炎患儿242例(39.5%),其中15例(2.5%)发展为重症肺炎。EBV-DNA阳性与阴性患儿比较,合并肺炎情况差异有统计学意义(P<0.05)。logistic回归分析显示,相比正常体温,最高体温区间37.3~<38℃的OR值为6.165,肝脏肿大、白细胞计数及补体C3的OR值分别为3.525、0.952、4.605(均P<0.05)。结论:EBV-DNA阳性患儿不同年龄段分布情况不同,最高体温、肝脏肿大、白细胞计数及补体C3为EBV-DNA阳性合并肺炎的相关因素。

Objective:To investigate the correlation between Epstein-Barr virus(EBV)DNA and pneumonia in children,and to improve clinicians'understanding of the diagnosis and treatment of EBV-infected children.Methods:612 EBV-DNA-positive children hospitalized in Huizhou Central People's Hospital and Huizhou First Maternal and Child Health Care Hospital from May 2021 to April 2023 were retrospectively selected,and 1,178 EBV-DNA-negative children hospitalized during the same period were collected as the control group.EBVDNA-positive children were divided into the pneumonia group(n=242)and the non-pneumonia group(n=347)according to the presence or absence of combined pneumonia,and logistic regression analyses were used to explore the correlation between EBV-DNA and pneumonia in children.Results:Among 612 EBV-DNA-positive children,the male to female ratio was 1.35:1.The age of onset was 3 months to 13 years,with 21 cases(3.4%)in infancy,136 cases(22.2%)in toddlerhood,319 cases(52.1%)in preschool,and 136 cases(22.2%)in school-age,and the peak age of the patients was in preschool.The number of EBV-DNA-positive combined pneumonias was 242 cases(39.5%),of which 15 cases(2.5%)developed severe pneumonia.The difference between EBVDNA-positive and negative children with combined pneumonia was statistically significant(P<0.05).Logistic regression analysis showed that compared to the normal body temperature,the OR value of the maximum temperature range of 37.3 to<38℃ was 6.165,and the OR values of hepatomegaly,white blood cell count and complement C3 were 3.525,0.952,and 4.605,respectively(all P<0.05).Conclusion:The distribution of EBV-DNA-positive children varies in different age groups,and maximum body temperature,hepatomegaly,white blood cell count,and complement C3 are correlates of EBV-DNA-positive combined pneumonia.