儿童自身免疫性疾病人细小病毒B19感染及其临床特征

目的探讨儿童自身免疫性疾病(AD)人细小病毒B19(B19)的感染情况及其临床特征。方法采用巢式聚合酶链反应(nPCR)技术检测133例AD患儿血清(BS)或骨髓(BM)标本B19-DNA。另设35例健康儿童为对照组。结果AD患儿B19-DNA总阳性率为29.3%,与对照组比较差异有统计学意义(P<0.01)。62例过敏性紫癜(AP)患儿BS标本B19-DNA阳性率20.9%,与对照组比较差异无统计学意义(P>0.05)。30例幼年特发性关节炎(JRA)B19-DNA阳性率40.0%(12/30例),与对照组比较差异有统计学意义(P<0.01);全身型、多关节型和少关节型B19-DNA阳性率依次为44.4%、36.4%和40.4%,两两比较差异无统计学意义(P>0.05)。结论AD可能与B19感染有关,感染的临床表现多种多样;B19感染相关性AP临床表现多样,症状重,关节症状更突出;B19相关性JRA可表现为JRA各型。

Epidemiological and clinical manifestation of human parvovirus B19 infection in children with autoimmune diseases

Objectives To explore the epidemiological and clinical manifestation of human parvovirus B19(B19)infection in children with autoimmune disease(AD). Methods The nested polymerase chain reaction assay(nPCR)was used to detect B19-DNA in the serum and/or bone marrow in 133 children with AD and 35 normal children as control,respectively. Results (1)The total positive rate of B19-DNA was 29.3% in children with AD,and there was the very significant difference in comparison with that in the control group(P < 0.01=. (2)The positive rate of serum B19-DNA was 20.9% in 62 cases with anaphylactoid purpura(AP),and no significant difference was found comparing with that in control group(P > 0.05). (3)The positive rate of serum B19-DNA was 40.0% in 30 cases with juvenile rheumatoid arthritis(JRA),the difference was very significant in comparison with that in the control group(P < 0.01=. (4)The positive rates of systemic JRA,polyarticular JRA,and pauciarticular JRA were 44.4%,36.4% and 40.0%,respectively,and no significant differences were observed when comparing with each corresponding control group(P > 0.05 for all). Conclusions (1)AD may correlated with B19 infection,and with diverse clinical manifestation. (2)Clinical manifestation of B19 infection associated AP may be various and severe,in particular with prominent symptoms of the joint. (3)JRA associated with B19 infection may manifest various subtypes of JRA.