儿童传染性单核细胞增多症的热程与EB病毒DNA阳性率和拷贝数相关性及临床意义的探讨

摘要

Objective To explore correlations of fever' s periods and positive percents of Epstein-Barr virus ( EBV ) infection detected by DNA copies, and the value for diagnosis of children Infectious Mononucleosis (IM). Methods We analyzed retrospectively 32 children IM cases of suffering high fever in our department from May 2011 to May 2012. The days of fever starting were analyzed to observe whether existed a relationship with percents and copies of positive EBV-DNA infections. Results The positive percent of EBV-DNA was 68. 75% (20/32). The number of DNA copies was 1. 39×107/ml ( mean) or 8. 36x 10 /ml ( median) . The time of detection were 6. 6 days ( mean) or 8.0 days (median). The positive percents of EBV-DNA before treatment were 91. 67% for fever day 1 to 4, 61. 54% for fever day 5 to 8 , 33. 3% for fever day 9 to 12, 0 for fever day 13 to 16, respectively. The copies and positive percents of EBV-DNA for fever day 1 to 4 were significantly higher than other groups of fever days ( P< 0. 05). The positive percents of EBV-DNA decreased with a linear pattern when fever' s period prolonged. Correlation coefficient R was 0.99 (P<0.01). Conclusion Detection of EBV-DNA on early fever stage of children (from 1 to 4 days) had a high value for diagnosis of IM. However, this detection for EBV-DNA was less diagnosis value when children fever time was over 9 days.%目的 探讨儿童传染性单核细胞增多症(IM)的热程与EB病毒DNA(EBV-DNA)检测阳性率的相关性及临床诊断意义.方法 回顾性分析2011年5月至2012年5月住院的IM患儿32例,分析其热程与EBV-DNA阳性率和拷贝数的关系.结果 儿童IM治疗前EBV-DNA的阳性率为68.75％ (20/32),拷贝数平均为1.39×107/ml(中位数8.36×104/ml),检测时发病时间平均6.6天(中位数8.0天).患儿治疗前EBV-DNA的阳性率分别为1～4天91.67％、5～8天61.54％、9～12天33.33％、13～16天0.热程1～4天EBV-DNA的检出阳性率和拷贝数均高于其他各组,差异有显著性(P＜0.05).4组患儿EBV-DNA的阳性率随着热程的增加而呈直线下降,相关系数R=0.99(P＜0.05).结论 在患儿发热早期(1～4天)检测EBV-DNA对儿童IM的诊断有很高的价值,而发热9天以后,该项检测在临床诊断上意义不大.