Objective To explore the diagnostic value of Epstein Barr virus(EBV)DNA load and CD4+T lymphocytes in poor prognosis of infectious mononucleosis(IM)in children,so as to provide strong support for clinical decision-making.Method 120 children with IM admitted to the Department of Pediatrics of our hospital from January 2022 to January 2024 were selected as the IM group,100 children with EBV infection who did not develop into IM were selected as the non-IM group,and 90 healthy children with physical examination were selected as the control group.Clinical data,peripheral blood T lymphocyte subsets and EBV DNA load were collected.According to the EBV DNA turned negative after 14 days of treatment,the children in IM group were further divided into a good prognosis group and a poor prognosis group.The differences among the groups were statistically analyzed and compared,and the diagnostic value of each index was evaluated by multivariate Logistic regression analysis and ROC curve.Result Before treatment,EBV-DNA load in IM group was significantly higher than that in non-IM group(P＜0.05),and CD4+T lymphocyte level was lower(P＜0.05).After 14 days of treatment,77.5％of the children in the IM group had negative EBV-DNA.The EBV-DNA load before treatment in the poor prognosis group was significantly higher than that in the good prognosis group(P＜0.05),and the CD4+T lymphocyte level was lower(P＜0.05).Multivariate Logistic regression analysis showed that EBV DNA load,white blood cell(WBC),lymphocyte(Lym),abnormal lymphocyte count,norepin ephrine(NE),CD4+T lymphocytes,CD4+/CD8+T lymphocytes levels were all factors affecting the poor prognosis of children with IM.ROC curve analysis showed that EBV DNA load combined with CD4+T lymphocytes was more effective in predicting prognosis than a single indicator.Conclusion EBV DNA load and CD4+T lymphocyte level are important indicators to predict the prognosis of children with IM,and the combined detection of EBV DNA load and CD4+T lymphocyte level can significantly improve the diagnostic efficiency.
关键词
EB病毒DNA载量/CD4+T淋巴细胞/儿童传染性单核细胞增多症/预后不良/诊断价值
Key words
Epstein Barr virus DNA load/CD4+T lymphocyte/Infectious mononucleosis in children/Poor prognosis/Diagnostic value
万方数据