儿童EB病毒相关性噬血淋巴组织细胞增生症的病毒学特征

首都医科大学学报 ›› 2005, Vol. 26 ›› Issue (5): 568-570.

儿童EB病毒相关性噬血淋巴组织细胞增生症的病毒学特征

谢正德, 段红梅, 张辉, 闫静, 刘亚谊, 申昆玲

首都医科大学附属北京儿童医院病毒研究室

收稿日期:2005-08-20 修回日期:1900-01-01 出版日期:2005-10-24 发布日期:2005-10-24

Virological Features of Epstein-Barr Virus Associated Hemophagocytic Lymphohistiocytosis in Children Cases

Xie Zhengde, Duan Hongmei, Zhang Hui, Yan Jing, Liu Yayi, Shen Kunling

Virology Laboratory, Beijing Children′s Hospital, Capital University of Medical Sciences

Received:2005-08-20 Revised:1900-01-01 Online:2005-10-24 Published:2005-10-24

摘要/Abstract

摘要：

目的了解儿童EB病毒(Epstein-Barr virus,EBV)相关性嗜血淋巴组织细胞增生症(EBV-associated hemophagocyticlymphohistiocytosis,EBV-HLH)的血清学EB病毒抗体和病毒复制水平等病毒学特征。方法对26例嗜血淋巴组织细胞增生症(HLH)和23例原发性EBV感染所致的传染性单核细胞增多症(EBV-associated,infectious mononucleosis,EBV-IM),用荧光定量PCR检测患者血清中EBV-DNA拷贝数,同时用间接免疫荧光法检测4项EBV抗体,包括:抗EBV衣壳抗原(capsid antigen,CA)IgG(EBV-CA-IgG)抗体、抗EBV衣壳抗原IgM(EBV-CA-IgM)抗体、抗EBV早期抗原(early antigen,EA)IgG(EBV-EA-IgG)抗体、抗EBV核抗原(nuclear antigen,NA)IgG(EBV-NA-IgG)抗体。结果 7例HLH患者血清中EBV-DNA检测阳性,被诊断为EBV-HLH。EBV-HLH患者血清中EBV-DNA拷贝数均值为(4.586±0.107)×10⁷/mL。从4项EBV抗体结果分析,原发感染3例(抗EBV-NA-IgG抗体阴性),既往感染或再激活4例(抗EBV-NA-IgG抗体阳性)。7例EBV-HLH患者中有3例EBV-CA-IgM阳性。23例EBV-IM患者血清中EBV-DNA检测均阳性,拷贝数均值为(6.865±0.305)×10³/mL。EBV-HLH患者血清中EBV-DNA拷贝数显著高于EBV-IM患者血清中EBV-DNA拷贝数,二者比较差异有统计学意义(P=0.000)。结论 EBV-HLH可以发生在EBV感染的不同时期,EBV-HLH患者血清中EBV-DNA拷贝数显著高于IM患者,外周血中EBV-DNA荧光定量PCR检测在EBV-HLH的病因诊断中比血清学抗体检测更具价值。

关键词: 嗜血淋巴组织细胞增生症, 传染性单核细胞增多症, EB病毒, 荧光定量PCR

Abstract:

Objective To analyze virological features of Epstein-Barr virus associated hemophagocytic lymphohistiocytosis in children cases.Methods The patients including 26 children with hemophagocytic lymphohistiocytosis(HLH) and 23 children with infectious mononucleosis(IM).EBV-DNA loads in sera were detected by real-time PCR assay with a commercial kit.Four antibodies,including EBV-IgG/M anti-VCA,EBV-IgG anti-EA,EBV-IgG anti-NA,were detected in sera of HLH cases.Results Seven HLH cases with positive of EBV-DNA in sera were diagnosed as Epstein-Barr virus associated hemophagocytic lymphohistiocytosis(EBV-HLH).The mean EBV-DNA loads in sera of patients with EBV-HLH were(4.586±0.107)×10⁷ copies/mL.Of 7 EBV-HLH, there were 3 primary EBV infections(EBV-IgG anti-NA negative) and 4 reactivated or past EBV infections(EBV-IgG anti-NA positive).All IM cases were positive of EBV-DNA in sera and mean EBV-DNA loads were((6.865±)0.305)×10³ copies/mL.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM(P=0.000).Conclusion EBV-HLH may occur in different stages of EBV infection.Detection of EBV-DNA in sera by real-time PCR was more practical in diagnosing EBV-HLH than antibody detection.There were significant differences of EBV-DNA loads in sera of patients between EBV-HLH and IM.

Key words: hemophagocytic lymphohistiocytosis, infectious mononucleosis, Epstein-Barr virus, real-time PCR

中图分类号:

R373
R725

谢正德;段红梅;张辉;闫静;刘亚谊;申昆玲. 儿童EB病毒相关性噬血淋巴组织细胞增生症的病毒学特征[J]. 首都医科大学学报, 2005, 26(5): 568-570.

Xie Zhengde;Duan Hongmei;Zhang Hui;Yan Jing;Liu Yayi;Shen Kunling. Virological Features of Epstein-Barr Virus Associated Hemophagocytic Lymphohistiocytosis in Children Cases[J]. Journal of Capital Medical University, 2005, 26(5): 568-570.