传染性单核细胞增多症患儿EBV-DNA载量及Treg、Breg细胞与临床转归的关系

Relationship between EBV-DNA load,Treg cells,Breg cells and clinical outcomes in children with infectious mononucleosis

目的探讨传染性单核细胞增多症(IM)患儿EB病毒(EBV)-DNA载量及调节T(Treg)细胞、调节B(Breg)细胞与临床转归的关系。方法选取2020年5月-2023年5月丽水市中心医院收治的80例IM患儿为本次研究对象,采用荧光定量聚合酶链式反应(qPCR)检测患儿外周血EBV-DNA载量,根据EBV-DNA载量分析结果分为低载量组(n=34)、中载量组(n=20)和高载量组(n=26);采用流式细胞术检测患儿外周血T淋巴细胞亚群(CD_(3)^(+)、CD_(3)^(+)CD_(4)^(+)、CD_(3)^(+)CD_(8)^(+)、CD4/CD8)、CD_(4)^(+)CD_(25)^(+)CD_(127)^(low)Treg、CD_(19)^(+)CD_(24)^(high)CD_(27)^(+)Breg细胞水平,酶联吸附试验检测白细胞介素(IL)-10、转化生长因子(TGF)-β,观察三组患儿临床转归情况。结果低载量组CD_(3)^(+)、CD_(3)^(+)CD_(8)^(+)细胞水平均低于中载量组和高载量组,中载量组低于高载量组(P<0.05);低载量组CD_(3)^(+)CD_(4)^(+)、CD_(4)^(+)CD_(25)^(+)CD_(127)^(low)、CD_(19)^(+)CD24^(high)CD_(27)^(+)细胞水平、CD4/CD8比值、IL-10、TGF-β水平均高于中载量组和高载量组,中载量组高于高载量组(P<0.05);低载量组住院时间、临床症状(发热、咽峡炎、淋巴结肿大、肝脾肿大、眼睑肿大)缓解时间均短于中载量组和高载量组,中载量组均短于高载量组(P<0.05)。结论EBV-DNA载量、Treg、Breg细胞表达水平均可对IM患儿的病情进行评估,且与临床转归情况有关。

OBJECTIVE To explore the relationship between Epstein-Barr virus(EBV)-DNA load,regulatory T(Treg)cells,regulatory B(Breg)cells and clinical outcomes in children with infectious mononucleosis(IM).METHODS A total of 80 children with IM admitted to Lishui Central Hospital between May 2020 and May 2023 were enrolled as the research objects.EBV-DNA load in peripheral blood was detected by fluorescence quantitative polymerase chain reaction(qPCR).According to EBV-DNA loads,children were divided into the low load group(n=34),medium load group(n=20)and high load group(n=26).The levels of peripheral blood T lymphocyte subsets(CD_(3)^(+)、CD_(3)^(+)CD_(4)^(+)、CD_(3)^(+)CD_(8)^(+)、CD4/CD8 ratio),CD_(4)^(+)CD_(25)^(+)CD_(127)^(low)Treg and CD_(19)^(+)CD_(24)^(high)CD_(27)^(+)Breg were detected by flow cytometry.The levels of interleukin(IL)-10 and transforming growth factor(TGF)-βwere detected by enzyme-linked immunosorbent assay(EILSA).The clinical outcomes among the three groups were observed.RESULTS The levels of CD_(3)^(+)and CD_(3)^(+)CD_(8)^(+)cells in the low load group were lower than those in the medium load group and the high load group,and the medium load group was lower than the high load group(P<0.05).The levels of CD_(3)^(+)CD_(4)^(+)、CD_(4)^(+)CD_(25)^(+)CD_(127)^(low)、CD_(19)^(+)CD24^(high)CD_(27)^(+)cells,CD4/CD8 ratio,IL-10 and TGF-βin the low load group were higher than those in the medium load group and the high load group,and the medium load group was higher than the high load group(P<o.05).The hospitalization time and remission time of clinical symptoms(including fever,angina,lymph node enlargement,liver-spleen enlargement and eyelid enlargement)in the low load group were shorter than those in the medium load group and the high load group,and those in the medium load group were shorter than those in the high load group(P<0.05).CONCLUSION The higher EBV-DNA load,Treg and Breg cells can evaluate disease severity in IM children,which are also related to clinical outcomes.