检测传染性单核细胞增多症患者外周血单个核细胞EB病毒DNA的临床意义

摘要

Objective Fluorescent Quantitative PCR was used to determine Epstein-Barr virus (EBV) DNA in peripheral blood mononuclear cells (PBMC) of patients with infectious mononucleosis (IM). Methods EBV DNA in 38 patients with IM were detected by Fluorescent Quantitative PCR and EBV VCR-IgM in plasma of peripheral blood were detected by Enzyme-Linked Immunoserbent Assay (ELISA) at seven days, one month, three months, six months and nine months after setup. Results At 7 days after setup, the positive rate of EBV DNA in PBMC was 89.0 % (34/38) and that of EBV VCR-IgM was 57.9 % (22/38). The positive percent in PBMC was significant higher than that in EBV VCR-IgM (P < 0.05 ). The positive rate of EBV-DNA in peripheral blood was 42.1% (16/38), showing no difference from EBV VCR-IgM in plasma(P > 0.05 ). The positive rate of EBV-DNA in PBMC was significant different from that in plasma (P < 0.05 ). 2 cases of EBV DNA positive in plasma and 17eases of EBV DNA positive in PBMC were found at 1 month after setup. The results of EBV DNA in plasma were negative. Conclusion EBV DNA in PBMC may be an early, rapid and sensitive diagnosis method on IM in the early stage of EBV infection. EBV DNA in PBMC detected by Fluorescent Quantitative PCR is an effective technique of determining therapy and monitoring disease progress. EBV infection in PBMC may be related to systematic injury in patients of infectious mononucleosis.%目的 应用荧光定量聚合酶链反应方法检测传染性单核细胞增多症患者外周血单个核细胞中的EB病毒DNA含量,探讨EB病毒感染单个核细胞的临床意义.方法 应用荧光定量聚合酶链反应检测38例传染性单核细胞增多症患者发热7d内,起病1、3、6、9个月外周血单个核细胞(PBMC)及血浆中EB病毒DNA,应用酶联免疫吸附法检测血清EB病毒衣壳抗原IgM.结果 38例患者在EB病毒感染发病7 d内,PBMC中EB病毒DNA检出阳性34例,阳性率为89.5%(34/38);EB病毒衣壳抗原lgM检出阳性22例,阳性率为57.9%,二者差异有统计学意义(X2=9.388,P<0.05);血浆EB病毒DNA检出阳性16例,阳性率为42.1%,与EB病毒衣壳抗原IgM比较,差异无统计学意义(X2=2.05,P>0.05);PBMC与血浆中EB病毒DNA比较,差异有统计学意义(X2=16.05,P<0.05).起病后1个月,血浆EB病毒DNA阳性2例、PBMC中EB病毒DNA阳性17例;起病后3、6、9个月血浆EB病毒DNA均为阴性,而PBMC中EB病毒DNA分别检出6例、4例、3例阳性.结论 EB病毒感染初期,检测外周血单个核细胞EB病毒DNA,可作为传染性单核细胞增多症早期、快速、敏感的诊断方法;EB病毒可长期存在于单个核细胞中,荧光定量聚合酶链反应方法检测PBMC中EB病毒DNA亦可作为判断疗效及监测病情的一种有效手段.EB病毒感染患者表现出多系统损伤可能与PBMC中EB病毒感染相关.