Han Xiucui, Xu Pengfei, Xu Hui
Clin Lab. 2020 Nov 1;66(11). doi: 10.7754/Clin.Lab.2020.191233.
Epstein-Barr virus infection is common in children. The aim of this study was to find new laboratory indices of infectious mononucleosis in children.
In this prospective study, a total of 141 children with infectious mononucleosis and 146 children without signs of infectious mononucleosis were enrolled. The number of white blood cell count (WBC) and red blood cell count (RBC), levels of hemoglobin (HB), mean blood cell volume (MCV), red blood cell distribution width (RDW), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), uric acid (UA), and creatinine (CREA) in the peripheral blood were evaluated.
WBC, RDW, ALT, AST, GGT, and UA in patients were significantly higher compared to controls (p < 0.01, for all), while RBC and HB were significantly lower in patients (p < 0.01, for each). In the stepwise regression analysis, we found that RDW had the highest ratio compared to other parameters, and its 95% confidence interval was 1.362 - 7.929 (p < 0.01). RDW was positively correlated with ALT, AST, and GGT elevations (p < 0.01). While RDW was negatively correlated with HB (p = 0.01). When using the criteria of RDW (%) = 12.55, the sensitivity was 80.9%, and the specificity was 78.8% in IM patients.
RDW may be used as a further indicator supporting early IM diagnosis and indirectly predicting the degree of liver cell damage in EBV infectious mononucleosis.
爱泼斯坦-巴尔病毒感染在儿童中很常见。本研究的目的是寻找儿童传染性单核细胞增多症的新实验室指标。
在这项前瞻性研究中，共纳入了141例传染性单核细胞增多症患儿和146例无传染性单核细胞增多症体征的儿童。评估外周血中白细胞计数（WBC）、红细胞计数（RBC）、血红蛋白（HB）水平、平均血细胞体积（MCV）、红细胞分布宽度（RDW）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转移酶（GGT）、尿酸（UA）和肌酐（CREA）。
与对照组相比，患者的WBC、RDW、ALT、AST、GGT和UA显著更高（均p < 0.01），而患者的RBC和HB显著更低（均p < 0.01）。在逐步回归分析中，我们发现RDW与其他参数相比比值最高，其95%置信区间为1.362 - 7.929（p < 0.01）。RDW与ALT、AST和GGT升高呈正相关（p < 0.01）。而RDW与HB呈负相关（p = 0.01）。当使用RDW（%） = 12.55的标准时，在传染性单核细胞增多症患者中的敏感性为80.9%，特异性为78.8%。
RDW可作为支持传染性单核细胞增多症早期诊断并间接预测EBV传染性单核细胞增多症中肝细胞损伤程度的进一步指标。
