传染性单核细胞增多症患儿EB病毒DNA载量与肝功能损害关系研究

Correlation between Epstein-Barr Virus DNA Load and Liver Function Damage in Children with Infectious Mononucleosis

路璐 ¹姜丽娜 ¹王颖慧 ¹丁瑛雪 ¹杨兵宾²

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作者信息

1. 首都医科大学附属北京友谊医院儿科,北京 100050
2. 中国中医科学院望京医院儿科,北京 100102
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摘要

目的:探讨传染性单核细胞增多症(IM)患儿EB病毒(EBV)-脱氧核糖核酸(DNA)载量与肝损害的关系.方法:纳入2016 年2 月至2023 年3 月期间在我院儿科确诊的126 例IM患儿为研究对象(IM组),另选同期 50 例健康儿童为对照组.比较 IM 组和对照组的肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL)].根据是否发生肝功能损坏将IM组患儿分为肝损害组(76 例)和非肝损害组(50 例),比较各组肝功能指标水平.采用 Spearman 等级相关分析评估 EBV-DNA载量与肝功能指标的关系,并绘制ROC曲线分析EBV-DNA载量和肝功能指标对肝功能损害的预测能力.结果:IM组患儿 ALT、AST 和 TBIL 水平均升高,且高于对照组(P<0.05).肝损害组患儿ALT、AST、TBIL水平和EBV-DNA 载量均高于非肝损害组(P<0.05).Spearman 等级相关分析显示,EBV-DNA载量与ALT(r=0.652,P<0.05)、AST(r=0.628,P<0.05)、和 TBIL(r=0.634,P<0.05)呈正相关.Logistic回归分析显示,ALT、AST、TBIL和EBV-DNA载量升高均是导致IM肝功能损害的影响因素.ROC曲线分析结果,EBV-DNA载量、ALT、AST和TBIL单独预测肝功能损害的曲线下面积(AUC)分别为0.868、0.830、0.821、0.681,而联合预测的AUC 为 0.962,灵敏度为 0.908,特异度为 0.920.结论:IM患儿EBV-DNA载量与肝功能损害程度密切相关,其中高载量组患儿的肝功能受损风险较高,提示在临床管理中应密切监测肝功能指标的变化,以减轻肝损伤的风险.

Abstract

Objective:To investigate the relationship between Epstein-Barr virus(EBV)-deoxyribonu-cleic acid(DNA)load and liver function damage in children with infectious mononucleosis(IM).Methods:Totally 126 IM children who were diagnosed in department of pediatrics of our hospital from February 2016 to March 2023 were included as the IM group,and 50 healthy children during the same period as the control group.The liver function indexes such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)were compared between the control group and the IM group.Children in the IM group were divided into liver damage subgroup(76 cases)and non-liver damage subgroup(50 cases)according to the presence or absence of liver function damage,and the levels of liver function indexes were compared.The correlation between EBV-DNA load and liver function damage was assessed by Spearman rank correlation analysis,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive a-bility of EBV-DNA load and liver function damage.Results:The levels of ALT,AST,and TBIL in the IM group were significantly increased,and which were significantly higher than those in the control group(P<0.05).The levels of ALT,AST and TBIL and EBV-DNA load were significantly higher in the liver damage sub-group compared to the non-liver damage subgroup(P<0.05).Spearman rank correlation analysis showed that EBV-DNA load was positively correlated with ALT,AST,and TBIL(r=0.652,0.628,0.634,respective-ly;all P<0.05).Logistic regression analysis demonstrated that increased ALT,AST,TBIL and EBV-DNA load were influencing factors for liver function damage.ROC curve analysis results revealed that the area under the curve(AUC)of EBV-DNA load,ALT,AST,and TBIL alone in predicting liver function damage was 0.868,0.830,0.821 and 0.681,respectively,and while the AUC of combined prediction was 0.962,with the sensitivity of 0.908 and the specificity of 0.920.Conclusion:EBV-DNA load is closely related to the degree of liver function damage in IM children,and the risk of liver function damage is higher in the high load group,suggesting that the liver function indexes should be closely monitored in clinical management to relieve the risk of liver damage.

关键词

传染性单核细胞增多症/EB病毒/脱氧核糖核酸载量/肝功能损害

Key words

Infectious mononucleosis/EB virus/Deoxyribonucleic acid load/Liver function damage

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出版年

2024

河北医学

河北省医学会

河北医学

CSTPCD

影响因子：1.915

ISSN：1006-6233

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