The value of anti-Epstein-Barr virus capsid antigen IgM,EBV DNA and atypical lymphocyte in the diagnosis of infectious monocytosis in children
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摘要: 目的 分析EBV-CA IgM、EBV DNA及外周血异型淋巴细胞用于诊断婴幼儿传染性单核细胞增多症(infectious mononucleosis,IM)的临床价值。 方法 回顾性分析中国科学技术大学附属第一医院2017年10月—2019年3月传染性单核细胞增多症患儿共32例(观察组),及同期入院非传染性单核细胞增多症患儿33例(对照组)。分别采用ELISA、定量PCR和外周血抗凝样本涂片镜检检测2组患儿的EBV-CA IgM、血清EBV DNA以及异型淋巴细胞占全血有核细胞百分比,并比较2组之间的差异。各项指标和联合检测的诊断价值用ROC曲线进行评价。 结果 观察组EBV-CA IgM、EBV DNA、异型淋巴细胞检测阳性率均显著高于对照组,差异有统计学意义(均P<0.05);3项指标并联联合检测敏感度(97.43%)明显高于3项指标单项检测。EBV-CA IgM、EBV DNA、异型淋巴细胞联合检测用于诊断IM的曲线下面积(AUC)为0.975,高于EBV-CA IgM(0.723)、EBV DNA(0.928)和异型淋巴细胞(0.961)单项检测。 结论 EBV-CA IgM、EBV DNA、异型淋巴细胞检测可作为诊断儿童IM的重要指标,联合检测能显著提高敏感度;有助于传染性单核细胞增多症的早期诊断,并降低误诊率。
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关键词:
- 传染性单核细胞增多症 /
- EBV-CAIgM抗体 /
- 异型淋巴细胞 /
- EB病毒DNA检测
Abstract: Objective To analyze the clinical value of anti-EBV capsid antigen IgM antibody(VCA-IgM), EBV DNA and peripheral blood atypical lymphocyte in diagnosing infectious mononucleosis(IM) in infants. Methods Total 32 children with IM(observation group) and 33 children with non-IM(control group) in the First Affiliated Hospital of USTC from October 2017 to March 2019 were retrospectively analyzed. ELISA, quantitative PCR and smear microscopy of peripheral blood anticoagulant samples were used to detect the VCA-IgM, serum EBV DNA and the percentage of atypical lymphocyte in the whole blood, and the differences between the two groups were compared. The diagnostic value of each index and the combined detection of the three indicators were evaluated by ROC curve. Results The positive rates of VCA-IgM, EBV DNA and atypical lymphocytes in the observation group were significantly higher than those in the control group(P<0.05). The sensitivity of combined detection of the three indicators(97.43%) was significantly higher than that of the three indexes alone. The area under the curve(AUC) of combined detection of the three indicators(0.975) for diagnosing IM was higher than that of EBV CA-IgM(0.723), EBV DNA(0.928) and atypical lymphocytes(0.961). Conclusion The detection of EBV VCA-IgM, EBV DNA and atypical lymphocytes can be used as important indicators for the diagnosis of IM in children, and the combined detection can significantly improve the sensitivity. It is helpful for the early diagnosis of IM and reduce the misdiagnosis rate.
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