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[儿童噬血细胞综合征的临床特征及其与人类细小病毒B19感染的关系]

[Clinical features of childhood hemophagocytic syndrome and its association with human parvovirus B19 infection].

作者信息

Wang Ying-Chao, Liu Dong-Jie, Ma Li-Na, Liu Man-Ju, Sheng Guang-Yao, Zhao Xiao-Ming

机构信息

Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2015 Jan;17(1):26-30.

PMID:25616288
Abstract

OBJECTIVE

To investigate the association of childhood hemophagocytic syndrome (HPS) with human parvovirus B19 (HPVB19) infection, and to analyze the clinical features of this disease.

METHODS

ELISA and quantitative real-time PCR were used to detect HPVB19-IgM, HPVB19-IgG and HPVB19-DNA in 65 children with HPS (HPS group) and 65 healthy children (control group). The HPS group was divided into HPVB19-infected (n=14) and non-infected (n=51) groups according to the detection results of HPVB19-DNA. The clinical data of two groups were compared.

RESULTS

The positive rate of HPVB19-IgM in the HPS group (26%, 17/65) was significantly higher than that in the control group (9%, 6/65) (P=0.011), and there was no significant difference in the positive rate of HPVB19-IgG between the HPS (38%, 25/65) and control groups (29%, 19/65) (P=0.266). The infection rate of HPVB19 in the HPS group (22%, 14/65) was significantly higher than that in the control group (3%, 2/65) (P=0.001). Compared with the non-infected group, the HPVB19-infected group had significantly lower platelet count and hemoglobin level on admission, significantly more severe liver function damage, a significantly earlier onset time, and a significantly longer course of disease (P<0.05).

CONCLUSIONS

The pathogenesis of HPS may be associated with HPVBl9 infection. HPVBl9-infected children with HPS have more acute onset, more severe clinical manifestations, and a longer disease duration.

摘要

目的

探讨儿童噬血细胞综合征(HPS)与人细小病毒B19(HPVB19)感染的相关性,并分析该疾病的临床特征。

方法

采用酶联免疫吸附测定(ELISA)和实时荧光定量聚合酶链反应(PCR)检测65例HPS患儿(HPS组)和65例健康儿童(对照组)的HPVB19-IgM、HPVB19-IgG及HPVB19-DNA。根据HPVB19-DNA检测结果,将HPS组分为HPVB19感染组(n = 14)和未感染组(n = 51)。比较两组的临床资料。

结果

HPS组HPVB19-IgM阳性率(26%,17/65)显著高于对照组(9%,6/65)(P = 0.011),HPS组(38%,25/65)与对照组(29%,19/65)的HPVB19-IgG阳性率差异无统计学意义(P = 0.266)。HPS组HPVB19感染率(22%,14/65)显著高于对照组(3%,2/65)(P = 0.001)。与未感染组相比,HPVB19感染组入院时血小板计数和血红蛋白水平显著降低,肝功能损害更严重,起病时间显著更早,病程显著更长(P < 0.05)。

结论

HPS的发病机制可能与HPVB19感染有关。HPVB19感染的HPS患儿起病更急,临床表现更严重,病程更长。

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Zhongguo Dang Dai Er Ke Za Zhi. 2015 Jan;17(1):26-30.
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