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目的 研究人类细小病毒B19感染与小儿常见风湿性疾病的关系。方法 用巢式PCR法对 95例小儿常见风湿性疾病患者进行B19 DNA检测 ,对部分患者进行B19 IgM检测。结果 (1)病例组B19 DNA阳性 33例 (34 7% ) ,健康对照组B19 DNA阳性 2例 (4 0 % ) ;病例组B19 DNA阳性率与对照组相比有显著差异 (P <0 0 1)。 (2 )病例组B19 IgM检测 5 0例 ,阳性 11例 (2 2 0 % ) ,健康对照组B19 IgM均为阴性 ;B19 IgM阳性率与对照组相比有显著差异 (P <0 0 1)。 (3)过敏性紫癜、幼年类风湿性关节炎、皮肌炎、系统性红斑狼疮、川崎病患儿B19 DNA及IgM阳性率分别为 2 5 %和 2 0 %、37 2 %和 2 0 %、4 0 %和 2 0 %、4 2 9%和 2 8 6 %、37 5 %和 2 5 0 %。五种风湿性疾病B19 DNA及IgM阳性率无显著差异 (P >0 0 5 )。 (4) 5 0例成对标本中 ,10例B19 DNA、IgM均阳性 ,1例仅B19 IgM阳性 ,7例仅B19 DNA阳性 ,B19 DNA和IgM同时阴性 32例 ,B19 DNA和IgM一致率为 84 0 % ,两者结果有一致性 (P <0 0 1) ;5 0例中B19 DNA阳性 17例 (34 0 % ) ,IgM阳性 11例 (2 2 0 % ) ,两者差异无显著意义(P >0 0 5 )。结论 (1)我国风湿性疾病患儿有较高的B19感染率。 (2 )B19与小儿风湿性疾病密切相关 ,可能是导致这些疾病的主要病原体之一
Objective To study the relationship between human parvovirus B19 infection and common rheumatic diseases in children. Methods B19 DNA was detected by nested PCR in 95 children with common rheumatic diseases and B19 IgM was detected in some patients. Results The positive rate of B19 DNA in case group was 33 (34.7%) and 2 (40%) in healthy control group. The positive rate of B19 DNA in case group was significantly different from that in control group (P <0 0) 1). (2) IgM was detected in 50 cases and 11 cases (220%) in group B19 and negative in group B19. The positive rate of IgM in B19 was significantly lower than that in control group (P <0.01) . (3) The positive rates of B19 DNA and IgM in children with allergic purpura, juvenile rheumatoid arthritis, dermatomyositis, systemic lupus erythematosus and Kawasaki disease were 25% and 20%, 37 2% and 20% , 40% and 20%, 429% and 286%, 37% and 25% respectively. There was no significant difference in the positive rates of B19 DNA and IgM between the five rheumatic diseases (P> 0.05). (4) Of the 50 specimens, 10 were positive for B19 DNA and IgM, 1 was positive for B19 IgM only, 7 were positive for B19 DNA only, 32 were negative for B19 DNA and IgM at the same time. The concordance rates of B19 DNA and IgM were The positive rate of B19 DNA was 34 (70%) and 11 (20.0%) of IgM were positive in 50 cases, but there was no significant difference between the two (P> 0 0 5). Conclusion (1) Children with rheumatic diseases in our country have a higher B19 infection rate. (2) B19 is closely related to pediatric rheumatic diseases and may be one of the major pathogens causing these diseases