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目的探讨外周血单个核细胞(PBMC)EB病毒负荷的荧光定量聚合酶链反应(PCR)检测在评估儿童传染性单核细胞增多症(IM)病情中的临床意义。方法选取2014年12月~2016年8月入住我院的IM患儿80例,于患儿起病7d内应用荧光定量PCR检测患儿PBMC及血浆中EB病毒DNA,按照PBMC中EB病毒DNA负荷量分为高病毒量组和低病毒量组。结果 80例患儿中,PBMC中EB病毒DNA检出阳性率为90.00%(72/80),血浆EB病毒DNA检出阳性率为42.50%(34/80),差异具有统计学意义(P<0.01);高病毒量组中重度肝脏肿大、中重度脾脏肿大分布率明显高于低病毒量组(P<0.01);高病毒量组患儿ALT、AST、CK、CK-MB水平均明显高于低病毒量组患儿(P<0.001);高病毒量组患儿热退时间、肝脾肿大消退时间、住院时间均明显长于低病毒量组患儿(P<0.001)。结论应用荧光定量PCR检测PBMC中EB病毒DNA可作为IM早期诊断方法,较血浆标本EB病毒DNA检出阳性率更高,同时也可用于患儿病情的评估。
Objective To investigate the clinical significance of fluorescent quantitative polymerase chain reaction (PCR) detection of Epstein-Barr virus (EBV) in peripheral blood mononuclear cells (PBMC) in the evaluation of the condition of childhood infectious mononucleosis (IM). Methods Eighty patients with IM were admitted to our hospital from December 2014 to August 2016. Fluorescent quantitative PCR was used to detect Epstein-Barr virus (EBV) DNA in PBMC and plasma in children within 7 days after onset of disease. According to the EBV DNA load The amount is divided into a high virus dose group and a low virus dose group. Results The positive rate of EBV DNA in PBMC was 90.00% (72/80) and the positive rate of plasma EBV DNA was 42.50% (34/80) in 80 children, the difference was statistically significant (P < 0.01). The distribution of ALT, AST, CK and CK-MB in high-virus group was significantly higher than that in low-virus group (P <0.01) (P <0.001). In the high viral load group, the children’s thermal back time, hepatomegaly splenomegaly and hospitalization time were significantly longer than those in the low-virus group (P <0.001). Conclusion The detection of Epstein-Barr virus (EBV) DNA in PBMC by fluorescence quantitative PCR can be used as an early diagnostic method for IM. The positive rate of Epstein-Barr virus DNA is higher than that of plasma samples, and it can be used to evaluate the condition of children.