CAJ | 학술논문

目的：分析 EB 病毒（EBV）抗体及 EBV DNA 的影响因素及关联性。方法回顾性分析2014年1－9月在北京大学第一医院就诊的143例患者的年龄、性别、血常规、肝功能、EBV 抗体及 DNA 检查结果，用 Spearman 相关性分析对 EBV 抗体及 EBV DNA 的相关影响因素进行分析，多个独立样本间比较使用 Kruskal －Wallis H 检验，独立样本间两两比较使用 Mann －Whitney U 检验。结果血清 EBV DNA（r ＝0．169～0．693，P ＜0．05）、EBV －VCA －IgM（r ＝0．153～0．434，P ＜0．05）均与外周血淋巴细胞 EBV DNA 、ALT、AST、ALP、GGT、白细胞（WBC）及异形淋巴细胞呈正相关，并且两者也呈正相关（r ＝0．434，P ＝0．00）；外周血淋巴细胞 EBV DNA 与血清EBV DNA、EBV －VCA －IgM、AST、ALP、WBC 及异形淋巴细胞呈正相关（r ＝0．207～0．693，P ＜0．05）。外周血淋巴细胞 EBV DNA 阳性率70．6％（101／143），血清 EBV DNA 阳性率32．2％（46／143）。EBV －VCA －IgM阳性率22．4％（32／143），22．5％（25／111）的 EBV－VCA －IgM阴性患者血清 EBV DNA 阳性。血清 EBV DNA 阳性患者 EBV －VCA －IgM阳性率（21／46，45．7％）明显高于外周血淋巴细胞 EBV DNA 阳性者（29／101，28．7％），差异有统计学意义（χ2＝7．95，P ＜0．01）。结论血清 EBV DNA 和 EBV －VCA －IgM有较强的关联性，并且前者的阳性率高于后者，更有助于 EBV 感染的早期诊断，联合检测两项指标可提高 EBV 现症感染的检出率。
목적：분석 EB 병독（EBV）항체급 EBV DNA 적영향인소급관련성。방법회고성분석2014년1－9월재북경대학제일의원취진적143례환자적년령、성별、혈상규、간공능、EBV 항체급 DNA 검사결과，용 Spearman 상관성분석대 EBV 항체급 EBV DNA 적상관영향인소진행분석，다개독립양본간비교사용 Kruskal －Wallis H 검험，독립양본간량량비교사용 Mann －Whitney U 검험。결과혈청 EBV DNA（r ＝0．169～0．693，P ＜0．05）、EBV －VCA －IgM（r ＝0．153～0．434，P ＜0．05）균여외주혈림파세포 EBV DNA 、ALT、AST、ALP、GGT、백세포（WBC）급이형림파세포정정상관，병차량자야정정상관（r ＝0．434，P ＝0．00）；외주혈림파세포 EBV DNA 여혈청EBV DNA、EBV －VCA －IgM、AST、ALP、WBC 급이형림파세포정정상관（r ＝0．207～0．693，P ＜0．05）。외주혈림파세포 EBV DNA 양성솔70．6％（101／143），혈청 EBV DNA 양성솔32．2％（46／143）。EBV －VCA －IgM양성솔22．4％（32／143），22．5％（25／111）적 EBV－VCA －IgM음성환자혈청 EBV DNA 양성。혈청 EBV DNA 양성환자 EBV －VCA －IgM양성솔（21／46，45．7％）명현고우외주혈림파세포 EBV DNA 양성자（29／101，28．7％），차이유통계학의의（χ2＝7．95，P ＜0．01）。결론혈청 EBV DNA 화 EBV －VCA －IgM유교강적관련성，병차전자적양성솔고우후자，경유조우 EBV 감염적조기진단，연합검측량항지표가제고 EBV 현증감염적검출솔。
Objective To study the relationship between Epstein -Barr virus (EBV)DNA and EBV antibody levels.Methods A retrospec-tive study was conducted on 143 patients who underwent EBV DNA testing in serum and lymphocytes from January to August,2014.The clini-cal data,including age,sex,blood routine and biochemical examination,serum/lymphocyte EBV DNA,EBV -VCA -IgM,and EBV -VCA -IgG were recorded.Spearman correlation analysis was used to measure the degree of the relationships.Kruskal -Wallis H test or Mann -Whitney U test were applied to compare the differences between three or two groups.Results The spearman rank correlation coeffi-cient between serum EBV DNA and EBV -VCA -IgMlevels was 0.434 (P =0.00),while the correlation coefficients of serum EBV DNA level and EBV -VCA -IgMlevel with lymphocyte EBV DNA,alanine aminotransferase (ALT),aspartate aminotransferase (AST),alka-line phosphatase (ALP),gamma -glutamyl transpeptidase (GGT),white blood cells (WBC),and heterotypic lymphocytes ranged from 0.169 to 0.693 (P <0.05)and from 0.153 to 0.434 (P <0.05),respectively.The spearman rank correlation coefficient of lymphocyte EBV DNA with serum EBV DNA,EBV -VCA -IgM,AST,ALP,WBC,and heterotypic lymphocytes ranged from 0.207 to 0.693 (P <0.05).The positive rates of EBV DNA in lymphocytes and serum were 70.6% (101 /143)and 32.2% (46/143),respectively.The EBV -VCA-IgMpositive rate was 22.4% (32 /143),and 22.5% (25 /111)of the patients with negative EBV -VCA -IgMwere positive for serum EBV DNA.The overall positive rate for EBV -VCA -IgG was 91.6% (131 /143).The EBV -VCA -IgM positive rate in patients with positive serum EBV DNA (21 /46,45.7%)was significantly higher than that in patients with positive lymphocyte EBV DNA (29 /101, 28.7%)(χ2 =7.95,P <0.01).Conclusion Serum EBV DNA level is strongly correlated with EBV -VCA -IgMlevel.Moreover,ser-um EBV DNA exhibits a higher positive rate than EBV -VCA -IgM.Simultaneous detection of serum EBV DNA and EBV -VCA -IgM may benefit the diagnosis of current EBV infection.