EB病毒抗体、异型淋巴细胞检测对儿童传染性单核细胞增多症的诊断价值

Diagnostic value of EBV antibodies and heterotypic lymphocytes in children with infectious mononucleosis

摘要:

目的 探讨EB病毒抗体、异型淋巴细胞检测对儿童传染性单核细胞增多症（IM）的诊断价值，为治疗儿童IM提供依据。方法 选取2020年7月—2022年12月在芜湖市第二人民医院就诊的IM患儿50例为观察组，同期该院健康体检者40例为对照组。外周血涂片细胞形态学检测异型淋巴细胞百分比、淋巴细胞亚群，化学发光法检测血清EB病毒IgM抗体，血常规检查白细胞水平。采用受试者工作特征（ROC）曲线分析EB病毒抗体、异型淋巴细胞百分比诊断儿童IM的价值。结果 观察组异型淋巴细胞百分比、EB病毒抗体、CD3⁺、CD8⁺和白细胞水平均高于对照组（P <0.05），CD4⁺、CD4⁺/CD8⁺水平均低于对照组（P <0.05）。ROC曲线分析结果显示，异型淋巴细胞百分比、EB病毒抗体诊断儿童IM的敏感性分别为82.4%（95% CI：0.772，0.872）和80.0%（95% CI：0.711，0.891），特异性分别为100.0%（95% CI：0.962，1.000）和90.4%（95% CI：0.863，0.944），其在诊断儿童IM中均具有较高价值。结论 根据异型淋巴细胞百分比、EB病毒抗体可以辅助诊断儿童IM，并能作为临床检测的主要手段。

Abstract:

Objective To investigate the diagnostic value of Epstein-Barr virus antibodies and atypical lymphocytes in pediatric infectious mononucleosis (IM), and to provide evidence to support clinical treatment decisions.Methods Fifty children with IM treated in the Second People's Hospital of Wuhu between July 2020 and December 2022 were included in the observation group, and 40 healthy individuals undergoing routine physical examination at the same hospital during the same period were enrolled as the control group. The percentage of atypical lymphocytes and lymphocyte subsets was determined by morphological analysis of peripheral blood smears. Serum Epstein-Barr virus IgM antibodies were measured using chemiluminescence immunoassay, and white blood cell counts were obtained through blood routine examination. Receiver operating characteristic (ROC) curve was used to analyze the value of Epstein-Barr virus antibodies and atypical lymphocytes in the diagnosis of infectious mononucleosis in children.Results The percentage of atypical lymphocytes, levels of Epstein-Barr virus antibodies, percentage of CD3⁺ cells, percentage of CD8⁺ cells, and white blood cell counts in the observation group were significantly higher than those in the control group (P < 0.05), while the percentage of CD4⁺ cells and the CD4⁺/CD8⁺ ratio in the observation group were significantly lower than those in the control group (P < 0.05). The ROC curve analysis revealed that the sensitivities of atypical lymphocyte percentage and Epstein-Barr virus antibody detection in diagnosing pediatric IM were 82.4% (95% CI: 0.772, 0.872) and 80.0% (95% CI: 0.711, 0.891), respectively, while their specificities reached 100.0% (95% CI: 0.962, 1.000) and 90.4% (95% CI: 0.863, 0.944), respectively. Both indicators demonstrated high diagnostic value for IM.Conclusion The percentage of atypical lymphocytes and Epstein-Barr virus antibody detection can assist in the diagnosis of pediatric IM and may serve as primary clinical diagnostic indicators.