细小病毒B19和儿童急性白血病关系的探讨

摘要

Objective To study the condition of B19DNA infection in child patients with acute leukemia and the correlation between B19 infection and acute leukemia. Methods 110 cases of acute leukemia from January 2011 to January 2015 were analyzed by the method of retrospective study. Two groups were included:GroupⅠcomprised 60 children with acute leukemia receiving chemo⁃therapy and Group Ⅱ comprised 50 children with recently diagnosed acute leukemia. Serum parvovirus B19 IgM were investigated by enzyme⁃linked immunosorbant assay and the virus DNA was sought by polymerase chain reaction assay in 110 cases of acute leukemia and 100 cases of healthy children. Results ①The positive rate of B19 DNA and/or B19 IgM in acute leukemia group was 55. 5%(61/110) and the control group was negative.②Viral DNA was found in 28.3% and B19 IgM was found in 33.3% of Group I patients;Viral DNA was found in 42.0% and B19 IgM was found in 52.0% of GroupⅡ. ③There was significant difference in incidence of ane⁃mia between B19 positive and negative children with acute leukemia. The former was 73.8%, the latter was 42.9%. There was signifi⁃cant difference in incidence of thrombocytopenia between B19 positive and negative children with acute leukemia. The former was 68.9%, the latter was 36.7%. Conclusion About half of the children with acute leukemia have been infected by B19. Children with recently diagnosed acute leukemia are more easily infected by parvovirus B19. Parvovirus B19 infection is an important cause of cytope⁃nia in children with acute leukemia.%目的：对急性白血病儿童细小病毒B19的感染及其影响进行探讨。方法回顾性分析某院2011年1月－2015年1月住院的110例急性白血病儿童的临床资料，把110例儿童分为两组：第1组：60名已接受化疗的急性白血病儿童；第2组：50例新发现的、未接受化疗急性白血病儿童；第3组：选取100例性别、年龄均匹配的儿童为健康对照组。采用聚合酶链反应（ PCR）技术检测细小病毒B19 DNA，ELISA法检测以上3组儿童的血清细小病毒B19 IgM抗体。结果①在110例患儿中，细小病毒B19 DNA和（或） IgM阳性的为61例，阳性率为55．5％；对照组均为阴性。②第1组细小病毒B19 DNA和IgM阳性率分别为28．3％和33．3％；第2组细小病毒B19 DNA和IgM阳性率分别为42．0％和52．0％。③细小病毒B19感染的急性白血病儿童贫血发生率为73．8％，无感染儿童贫血发生率为42．9％（ P＜0．05）；细小病毒B19感染的急性白血病儿童血小板减少发生率为68．9％，无感染儿童血小板减少发生率为36．7％（ P＜0．05）。结论50％左右的急性白血病儿童存在细小病毒B19感染；新发现、未接受化疗的急性白血病儿童更容易存在细小病毒B19感染；细小病毒B19感染是急性白血病儿童红细胞系和血小板减少的重要原因。