761例住院儿童EB病毒感染分析

Analysis of Epstein Barr virus infection in 761 hospitalized children

摘要:

目的：了解儿童EB病毒（EBV）感染情况，并分析其相关疾病谱，从而为EBV感染及相关疾病的防治提供科学的理论依据。方法：采用real-time PCR法检测2010年8月至2011年7月收治的761例（年龄22 d至14岁）疑似EBV感染儿童血浆中EBV-DNA载量，并对EBV-DNA检查结果及相关疾病进行统计学分析。结果：761例血浆标本中EBV-DNA阳性标本109例，阳性率为14.3%；不同年龄组EBV-DNA阳性检出率差异有统计学意义（P<0.05），其中婴儿组（<1岁）的阳性检出率最低（P<0.05）；不同季节间阳性检出率差异有统计学意义（P<0.05），其中夏季阳性检出率高于冬季（P<0.05）。109例阳性标本的EBV-DNA载量范围为2.13～6.69，中位数为3.72。对62例EBV-DNA阳性住院患儿最终临床诊断分析得出，呼吸系统疾病占39%，主要为急性支气管炎、急性上呼吸道感染及急性支气管肺炎。结论：不同年龄组及不同季节间EBV-DNA阳性检出率不同；儿童EBV感染相关疾病以呼吸系统疾病为主；Real-time PCR法检测血浆EBV-DNA有助于临床上EBV感染的早期诊断。

Abstract:

OBJECTIVE: To study the status of EB virus (EBV) infection and the spectrum of EBV infection-related diseases. METHODS: A total of 761 plasma samples with suspected EBV infection were collected from 761 children (aged from 22 days to 14 years) admitted between August 2010 and July 2011. EBV-DNA of 761 plasma samples was detected by real-time PCR. The epidemiological characteristics and final clinical diagnosis were analyzed based on the clinical data of these EBV-positive hospitalized patients. RESULTS: A total of 109 cases with EBV infection were detected by real-time PCR, with a positive rate of 14.3%. There were significant differences in the positive rate of EBV-DNA among different age groups and between seasons (P<0.05). The positive rate of EBV-DNA in the baby group (<1 year old) was lowest (P<0.05), and the positive rate of EBV-DNA in summer was higher than in winter (P<0.05). The range of plasma EBV-DNA level in children with EBV-DNA positivity was 2.13 to 6.69 (median 3.72). Based on the final diagnosis of 62 EBV-positive hospitalized children, the most common disease was respiratory system infection (39%), such as acute bronchitis, acute upper respiratory infection and bronchopneumonia. CONCLUSIONS: The EBV-DNA positive rate is different among different age groups and between seasons. Respiratory system infection is a leading disease in hospitalized children who are EBV-DNA positive. Real-time PCR assay is useful for rapid and reliable clinical diagnosis of EBV in children.