Zhang Qiang, Fang Qing-Feng, Yang Zhi, Chen Bi-Quan
Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230051, Anhui Province, China.
Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230051, Anhui Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Aug;30(4):1262-1266. doi: 10.19746/j.cnki.issn.1009-2137.2022.04.046.
To investigative the detection value of EB virus DNA (EBV-DNA), interleukin-2 (IL-2), and interleukin-6 (IL-6) level in peripheral blood of children with infectious mononucleosis (IM).
A total of 59 children clinically confirmed with IM in Anhui Provincial Children's Hospital from January 2018 to September 2020 were enrolled as IM group, while other 30 healthy children undergoing physical examination during the same period were enrolled as healthy group. The level of EBV-DNA load, IL-2, and IL-6 were compared between the two groups, and their diagnostic values for IM children were explored. According to the median level of EBV-DNA load, positive children were divided into high viral load group and low viral load group. The hepatomegaly and splenomegaly, and levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), IL-2, and IL-6 were compared between the two groups. The relationship between EBV-DNA load and IL-2, IL-6 levels were explored.
The positive rate of EBV-DNA was 67.80% in IM group, which was significantly higher than 10.00% in healthy group (P<0.001), and the levels of serum IL-2 and IL-6 were also significantly higher than healthy group (P<0.001). The results of ROC curve analysis showed that AUC of IL-2 combined with IL-6 and EBV-DNA load was 0.948, which was significantly greater than that of IL-2, IL-6, and EBV-DNA load alone (0.847, 0.728, 0.789) (P<0.001). The cut-off value of IL-2 and IL-6 was 15.545 pg/ml and 56.560 pg/ml, respectively. Both the proportions of cases with moderate to severe hepatomegaly and splenomegaly in high viral load group were significantly higher than those in low viral load group (P<0.01, P<0.05). The levels of ALT, AST, and IL-2 in high viral load group were significantly higher than those in low viral load group (P<0.001), as well as IL-6 (P<0.01). In high and low viral load groups, EBV-DNA load was positively correlated with IL-2 and IL-6 (in high viral load group, r=0.598, r=0.416; in low viral load group, r=0.621, r=0.527, P<0.001).
The detection of EBV-DNA load combined with IL-2 and IL-6 can improve the diagnostic accuracy of IM, and EBV-DNA load, IL-2 and IL-6 levels are related to the disease progression.
探讨EB病毒DNA（EBV-DNA）、白细胞介素-2（IL-2）及白细胞介素-6（IL-6）水平在传染性单核细胞增多症（IM）患儿外周血中的检测价值。
选取2018年1月至2020年9月在安徽省儿童医院临床确诊为IM的59例患儿作为IM组，同期30例健康体检儿童作为健康组。比较两组患儿EBV-DNA载量、IL-2及IL-6水平，探讨其对IM患儿的诊断价值。根据EBV-DNA载量中位数，将阳性患儿分为高病毒载量组和低病毒载量组。比较两组患儿肝肿大、脾肿大情况及丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、IL-2及IL-6水平。探讨EBV-DNA载量与IL-2、IL-6水平的关系。
IM组EBV-DNA阳性率为67.80%，显著高于健康组的10.00%（P<0.001），血清IL-2及IL-6水平也显著高于健康组（P<0.001）。ROC曲线分析结果显示，IL-2联合IL-6及EBV-DNA载量的AUC为0.948，显著大于单独检测IL-2、IL-6及EBV-DNA载量（0.847、0.728、0.789）（P<0.001）。IL-2及IL-6的截断值分别为15.545 pg/ml和56.560 pg/ml。高病毒载量组中、重度肝肿大及脾肿大的比例均显著高于低病毒载量组（P<0.01，P<0.05）。高病毒载量组ALT、AST及IL-2水平显著高于低病毒载量组（P<0.001），IL-6水平亦高于低病毒载量组（P<0.01）。在高、低病毒载量组中，EBV-DNA载量与IL-2及IL-6均呈正相关（高病毒载量组中，r=0.598，r=0.416；低病毒载量组中，r=0.621，r=0.527，P<0.001）。
检测EBV-DNA载量联合IL-2及IL-6可提高IM的诊断准确性，且EBV-DNA载量、IL-2及IL-6水平与疾病进展相关。
