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目的 了解EB病毒(EBV)感染患儿外周血血浆中游离EBV DNA的拷贝数,确定EBV原发感染后外周血血浆中EBV游离DNA的拷贝数与发病天数及病情轻重的关系.方法 应用荧光定量PCR方法,测定73例EBV原发感染和18例EBV相关重症疾病患儿外周血血浆中EBV游离DNA.结果 ①原发EBV感染患儿外周血血浆中EBV游离DNA随发病天数呈下降趋势,发病2周后很难检测到.②EBV相关重症疾病组患儿外周血血浆中EBV游离DNA阳性率明显高于原发EBV感染组,差异有显著性(89%vs 16%,P<0.05).结论 原发EBV感染后随病程天数的增加,病毒复制水平逐渐下降.血浆中EBV游离DNA检测对评价EBV相关疾病的严重程度有一定参考价值.“,”Objective To determine the plasma level of Epstein-Barr virus ( EBV) DNA in children with EBV-associated diseases, and to investigate the dynamic changes of EBV DNA level after initial infection as well as the relationship between EBV-DNA level and the diseases severity. Methods The subjects consisted of 73 children with primary EBV infection (infectious mononucleosis, pneumonia,etc. ) and 18 children with severe EBV-associated diseases (chronic active EBV infection, hemophagocytic lymphohistiocytosis, etc. ). The plasma EBV DNA level was detected by a real-time PCR assay. Results The plasma EBV DNA level decreased with the infection time in children with primary EBV infection. Two weeks after infection, plasma EBV DNA was almost undetectable. The positive rate of plasma EBV DNA in children with severe EBV-associated diseases increased significantly when compared with that in children with primary EBV infection (89% vs 16% ; P < 0.05). Conclusions The level of EBV replication may be reduced with the infection time. Dynamic determination of blood EBV DNA is useful for the evaluation of disease severity in children with EBV infection.