传染性单核细胞增多症或慢性活动性EB病毒感染患者的外周血淋巴细胞计数及慢性活动性EB病毒感染的预后危险因素

Peripheral blood lymphocyte counts in patients with infectious mononucleosis or chronic active Epstein-Barr virus infection and prognostic risk factors of chronic active Epstein-Barr virus infection.

作者信息

Lin Jiancheng, Chen Xiaokang, Wu Haiming, Chen Xiaoyun, Hu Xiaomei, Xu Jin

机构信息

Department of Clinical Laboratory, Children's Hospital of Xiamen (Children's Hospital of Fudan University at Xiamen) Xiamen 361006, Fujian Province, China.

Department of Clinical Laboratory, Children's Hospital of Fudan University Shanghai 201102, China.

出版信息

Am J Transl Res. 2021 Nov 15;13(11):12797-12806. eCollection 2021.

PMID:34956494

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8661241/

Abstract

OBJECTIVE

To explore the peripheral blood lymphocyte counts and analyze the prognostic risk factors for the death in patients with chronic active Epstein-Barr virus (CAEBV) infection.

METHODS

Clinical data of 64 patients infected with CAEBV (CAEBV group) and 64 patients with infectious mononucleosis (IM group) in our hospital were retrospectively analyzed. Meanwhile, 64 healthy individuals came for physical examination were enrolled in the control group. The three groups were compared for white blood cell count, lymphocyte count, and levels of peripheral blood NK cells, B cells, CD3, CD4, CD8, CD4CD28, CD8CD28, CD4CD25, DRCD8, CD38CD8, CD4 and CD8 naive T cells and subsets of memory T cells. Patients infected with CAEBV were further divided into a survival subgroup and a death subgroup according to the survival outcome. The data were processed using univariate analysis and multivariate logistic regression analysis.

RESULTS

Compared with the control group, the IM group had higher levels of white blood cell count, lymphocyte count, CD3, CD4, CD8, CD4CD25, DRCD8, CD38CD8, effector-memory CD4CD62LCD45RO and effector-memory CD8CD62LCD45RO, but lower levels of NK cells, B cells, CD4CD28, CD8CD28, naive CD4CD62LCD45RA and naive CD8CD62LCD45RA (all P<0.05). Compared with the control group, the CAEBV group had lower levels of white blood cell count, lymphocyte count, CD3, CD4, CD8, NK cells, B cells, CD4CD28, CD8CD28, naive CD4CD62LCD45RA and naive CD8CD62LCD45RA, but higher levels of CD4CD25, DRCD8, CD38CD8, effector-memory CD4CD62LCD45RO and effector-memory CD8CD62LCD45RO (all P<0.05). Univariate analysis and multivariate logistic regression analysis showed that EBV DNA>105 copies/mL, platelet count <50×10/L, albumin <30 g/L and serum ferritin >5000 μg/L were independent risk factors for the death of patients with CAEBV.

CONCLUSION

Patients infected with CAEBV showed imbalance of lymphocyte subsets and immune dysfunction. EBV DNA>105 copies/mL, platelet count <50×10/L, albumin <30 g/L and serum ferritin >5000 μg/L are risk factors of death in patients with CAEBV.

摘要

目的

探讨慢性活动性EB病毒（CAEBV）感染患者的外周血淋巴细胞计数，并分析其死亡的预后危险因素。

方法

回顾性分析我院64例CAEBV感染患者（CAEBV组）和64例传染性单核细胞增多症患者（IM组）的临床资料。同时，纳入64例前来体检的健康个体作为对照组。比较三组的白细胞计数、淋巴细胞计数以及外周血NK细胞、B细胞、CD3、CD4、CD8、CD4CD28、CD8CD28、CD4CD25、DRCD8、CD38CD8、CD4和CD8初始T细胞及记忆T细胞亚群。根据生存结局将CAEBV感染患者进一步分为生存亚组和死亡亚组。采用单因素分析和多因素logistic回归分析处理数据。

结果

与对照组相比，IM组白细胞计数、淋巴细胞计数、CD3、CD4、CD8、CD4CD25、DRCD8、CD38CD8、效应记忆性CD4CD62LCD45RO和效应记忆性CD8CD62LCD45RO水平较高，但NK细胞、B细胞、CD4CD28、CD8CD28、初始CD4CD62LCD45RA和初始CD8CD62LCD45RA水平较低（均P<0.05）。与对照组相比，CAEBV组白细胞计数、淋巴细胞计数、CD3、CD4、CD8、NK细胞、B细胞、CD4CD28、CD8CD28、初始CD4CD62LCD45RA和初始CD8CD62LCD45RA水平较低，但CD4CD25、DRCD8、CD38CD8、效应记忆性CD4CD62LCD45RO和效应记忆性CD8CD62LCD45RO水平较高（均P<0.05）。单因素分析和多因素logistic回归分析显示，EBV DNA>105拷贝/mL、血小板计数<50×10/L、白蛋白<30 g/L和血清铁蛋白>5000μg/L是CAEBV患者死亡的独立危险因素。