【摘要】 目的 评价外周血异常淋巴细胞(异淋)形态学的检查和实时荧光定量PCR技术检测EB病毒DNA定量在小儿传染性单核细胞增多症早期诊断中的价值。方法 回顾性分析了2013年1月~2014年12月收治的212例传染性单核细胞增多症的患儿,分别抽取其发热初期和1周后抗凝静脉血做外周血涂片细胞形态学检查和实时荧光定量PCR技术检测EBV-DNA定量。结合患儿初诊时的临床表现进行综合分析。异型淋巴细胞>10%及EBV-DNA定量超过1.0×10~3拷贝为阳性。结果 在212例传染性单核细胞增多症的惠儿中,发热初期外周血涂片细胞形态学检查,82例异型淋巴细胞阳性,100例外周血EBV-DNA定量阳性。1周后复检外周血,156例异型淋巴细胞阳性,最高可达56%;180例EBV-DNA定量阳性。联合检测外周血细胞形态学异型淋巴细胞及EBV-DNA定量,发热初期,阳性125例,较单纯外周血细胞形态学异型淋巴细胞检测(χ~2=17.45,P<0.01)及EBV-DNA定量检测(χ~2=5.92,P<0.05)均明显提高;但1周后,阳性190例,较单纯外周血细胞形态学异型淋巴细胞检测明显升高(χ~2=18.16,P<0.01),但与EBV-DNA定量检测比较,无明显提高(χ~2=2.12,P>0.05)。结论 联合检测外周血细胞学形态及EBV-DNA定量对早期诊断小儿传染性单核细胞增多症十分重要,结合临床表现,能提高诊断的及时性及准确性。更多还原

【Abstract】 Objective To evaluate the value of detecting abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus(EBV)DNA quantity through real-time quantitative PCR(RT-qPCR) in the initial diagnosis for infants patients with infectious mononucleosis(IM).Methods From Jan.2013 to Dec.2014 212 infants patients with IM were analysed retrospectively,which were all in-patients in the hospital.The abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus(EBV) DNA quantity were both detected in the initial fever period and a week later.The latter was detected by real-time quantitative PCR(RT-qPCR),combined with all the symptoms were all analysed comprehensively.The percentage of abnormal lymphocyte more than 10%was positive,and the EBV-DNA quantity more than 1.0×10~3 copy per ml was positive,too.Results Of all the infants patients,in the initial fever period,82 patients had more than 10%positive abnormal lymphocyte and 100 patients had positive EBV-DNA quantity.But a week later,156 patients had more than 10%positive abnormal lymphocyte,the maximum abnormal lymphocyte was 56%.And 180 patients had positive EBV-DNA quantity.When both abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus(EBV) DNA quantity were detected,in the initial fever period,125 patients were positive,it rose significantly more than that of abnormal lymphocyte morphology in peripheral blood(χ~2 = 17.45,P<0.01),and that of Epstein Barr Virus(EBV) DNA quantity,too(χ~2 =5.92,P<0.05).But a week later,190 patients were positive,it rose significantly more than that of abnormal lymphocyte morphology in peripheral blood(χ~2 =18.16,P<0.01).There was no significantly rising more than that of Epstein Barr Virus(EBV) DNA quantity(χ~2 = 2.12,P>0.05).Conclusion The detecting of peripheral blood cell morphology combined with EBV-DNA quantity are very important in the initial diagnosis for infants patients with infectious mononucleosis.Including all the symptoms,they could improve the diagnosis timely and accurately.更多还原