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目的:研究EB病毒(Epstein-barr virus,EBV)感染的儿童外周血单个核细胞(PBMC)中的EBV-DNA水平与疾病谱的相关性,进一步了解黑龙江省儿童EBV感染情况及流行特征。方法:选择2015年6月至2016年2月就诊于哈尔滨医科大学附属第二医院儿内科门诊疑似EBV感染收入院的患儿,用荧光定量PCR法检测外周血PBMC中的EBV-DNA含量,并收集相应临床资料。用χ2检验和秩和检验分析不同疾病中EBV-DNA水平的差异和不同EBV-DNA水平疾病谱的分布情况。结果:762例儿童中,EBV-DNA检测阳性329例,检出率为43.1%。在EBV-DNA阳性的患儿中,男性患儿198例,女性患儿131例,不同性别的阳性检出率比较无统计学差异(P=0.182);不同年龄的患儿EBV-DNA检出率的差异有统计学意义(P=0.000),学龄前组最高,婴儿组最低;EBV-DNA定量值虽然有学龄前组>学龄组>幼儿组>婴儿组的趋势,但是无统计学差异(P=0.337);主要疾病谱所占比例从高到低依次为:呼吸系统疾病、IM、脑炎、单纯EBV感染和血液系统疾病,其中呼吸系统疾病最多40例(42.6%);IM的EBV-DNA含量最高1.522e+004(6.55e+001-4.602e+006),并且与其他各组比较均有统计学差异(P=0.000),其余各组之间无统计学差异。EBV-DNA水平不同相关疾病谱亦有差异(P=0.00),同一EBV-DNA水平中每种疾病大于10%病例数分布在(1.00-9.99)e+001-(1.00-9.99)e+006,IM最高主要分布在(1.00-9.99)e+004-(1.00-9.99)e+006之间,其余疾病主要分布在(1.00-9.99)e+001-(1.00-9.99)e+005。结论:黑龙江地区儿童EBV感染率处于较高的水平,EBV-DNA水平高低与疾病谱密切相关。
OBJECTIVE: To study the correlation between Epstein-Barr virus (EBV-DNA) levels and disease spectrum in Epstein-Barr virus (EBV) -infected children with peripheral blood mononuclear cells (PBMCs) and further understand the EBV infection and epidemiological characteristics of children in Heilongjiang Province. Methods: From June 2015 to February 2016, infants with suspected EBV infection in pediatric outpatient department of Harbin Medical University Second Affiliated Hospital were enrolled. Fluorescent quantitative PCR was used to detect EBV-DNA in peripheral blood PBMCs. Collect the appropriate clinical data. Differences in EBV-DNA levels and distribution of disease spectrum at different EBV-DNA levels in different diseases were analyzed using χ 2 test and rank sum test. Results: Of the 762 children, EBV-DNA was detected in 329 cases, the detection rate was 43.1%. In EBV-DNA-positive children, 198 cases of male children and 131 cases of female children were detected, and the positive rate of different sexes was no significant difference (P = 0.182); EBV-DNA was detected in children of different ages The difference was statistically significant (P = 0.000), the highest in preschool group and the lowest in infancy group. There was no significant difference in the quantitative value of EBV-DNA between preschool group> school age group> infant group> infants group P = 0.337). The proportion of major disease spectrum from high to low was as follows: respiratory diseases, IM, encephalitis, simple EBV infection and hematological diseases, of which respiratory diseases were up to 40 (42.6%); IM EBV The highest content of DNA was 1.522e + 004 (6.55e + 001-4.602e + 006), which was significantly different from other groups (P = 0.000). There was no significant difference between the other groups. EBV-DNA levels were also related to different disease spectrum (P = 0.00), the same EBV-DNA levels of each disease is greater than 10% of the number of cases in the distribution of (1.00-9.99) e + 001- (1.00-9.99) e + 006 , The highest IM was mainly distributed in the range of (1.00-9.99) e + 004- (1.00-9.99) e + 006, the rest of the disease mainly distributed in the range of (1.00-9.99) e + 001- (1.00-9.99) e + 005. Conclusion: The EBV infection rate of children in Heilongjiang region is at a high level. The level of EBV-DNA is closely related to the disease spectrum.