血浆EB病毒DNA载量在儿童EB病毒相关噬血细胞综合征诊断中应用价值
Value of plasma EBV DNA load in diagnosis of EBV associated hemophagocytic lymphohistocytosis in children
贾静 1郭明发 2范朋凯 2谢昕 2栗春香 2周建文2
作者信息
- 1. 郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,郑州市儿童感染与免疫重点实验室,郑州 450000
- 2. 郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,河南省小儿血液医学重点实验室,郑州 450000
- 折叠
摘要
目的 检测儿童EB病毒相关噬血细胞综合征(EBV-related hemophagocytic lymphohistiocytosis,EBV-HLH)和非EBV-HLH患儿血浆EBV-DNA载量,探讨血浆EBV-DNA载量对儿童EBV-HLH的诊断价值.方法 回顾性收集河南省儿童医院EBV-HLH患者(2019年1月—2023年5月)及年龄、性别与其相匹配的血浆EBV+非HLH患者(2021年1月—2023年5月)临床资料.采用实时荧光定量PCR(real-time polymerase chain recation,R-T PCR)检测患者血浆EBV-DNA载量,以EBV+非HLH患者作为对照组,绘制ROC曲线,分析血浆EBV-DNA载量在儿童EBV-HLH诊断中的最佳截断值.结果 共入选符合诊断标准的EBV-HLH患者55例、对照组患者220例.相对于对照组,EBV-HLH组患者的白细胞计数、血红蛋白水平、血小板计数、纤维蛋白原水平低于非EBV-HLH组(P均＜0.05),甘油三酯、血清铁蛋白水平高于非EBV-HLH组(P均＜0.05).EBV-HLH组患者血浆EBV-DNA载量982(324,3280)×102 copies/mL,明显高于非EBV-HLH组5.54(5.16,10.72)×102 copies/mL(P＜0.001);血浆EBV-DNA载量诊断儿童EBV-HLH的最佳截断值为1.36×104 copies/mL,AUC为0.987(95％置信区间:0.974～0.999,P＜0.001),其灵敏度为94.90％,特异度为93.40％.结论 儿童血浆EBV-DNA载量超过1.36×104 copies/mL时,对诊断EBV-HLH有较好的敏感度与特异度.
Abstract
Objective To detect the plasma EBV-DNA load in children with EBV related hemophagocytic lymphohisti-ocytosis(EBV-HLH)and non EBV-HLH,and to investigate the diagnostic value of plasma EBV-DNA load in chil-dren with EBV-HLH.Methods We retrospectively collected the clinical data of ebv-hlh patients(January 2019-may 2023)and their age-and gender matched plasma EBV+non HLH patients(January 2021-may 2023)from Henan children's hospital.Quantitative real-time polymerase chain reaction(R-T PCR)was used to measure the EBV-DNA load in the plasma of the patients,and EBV+non HLH patients were used as the control group to draw the ROC curve to analyze the optimal cut-off value of plasma EBV-DNA load in the diagnosis of EBV-HLH in children.Results A total of 55 EBV-HLH patients who met the diagnostic criteria and 220 control patients were enrolled.Rela-tive to the control group,the white blood cell count,hemoglobin level,platelet count,fibrinogen level of EBV-HLH patients were lower than those of non EBV HLH patients(all P＜0.05),and the triglyceride and serum ferritin levels were higher than those of non EBV-HLH patients(all P＜0.05).Patients in the EBV-HLH group had a plasma EBV-DNA load of 982(324,3280)×102 copies/mL,which was significantly higher than the non EBV-HLH group 5.54(5.16,10.72)×102 copies/mL(P＜0.001);The optimal cutoff value of plasma EBV-DNA load for the diag-nosis of EBV-HLH in children is 1.36×104 copies/mL,with an AUC of 0.987(95％ confidence interval:0.974-0.999,P＜0.001),which yielded a sensitivity of 94.90％ and a specificity of 93.40％.Conclusion The plasma EBV-DNA load in children exceeded 1.36×104 copies/mL showing a good sensitivity and specificity for diagnosing EBV-HLH.
关键词
EBV/儿童/噬血细胞综合征Key words
EBV/Children/Hemophagocytic lymphohistiocytosis引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20190966)
河南省医学科技攻关计划联合共建项目(LHGJ20200606)
出版年
2024
NETL
NSTL
万方数据