荧光定量聚合酶链反应法检测咽拭子EBV-DNA在早期诊断EBV感染中的作用

目的 探讨咽拭子荧光定量聚合酶链反应（FQ-PCR）法检测非洲淋巴细胞瘤病毒脱氧核糖核（EBV—DNA）在早期诊断EBV感染中的应用价值。方法对于疑诊EBV感染的患儿在疾病初期分别采用咽拭子PCR法检测EBV—DNA，同时用酶联免疫吸附测定（ELISA）法检测静脉血EBV—VCA—IgM和（或）IgG，对于前者阳性而后者阴性的病例在1周后复查EBV—VCAIgM和IgG，比较两者在早期诊断EBV感染中的价值。同期检测健康儿童50例作为对照组。结果①共检测疑诊病例985例，其中EBV—DNA阳性344例，阳性率34．9％，EBV—VCA—IgM和（或）IgG阳性164例，阳性率16．6％；健康对照组检测50例，仅1例EBVDNA阳性，所有病例EBV—VCA—IgM和（或）IgG均阴性。②在纳入研究病例中，诊断为传染性单核细胞增多症者38例，其中EBV—DNA37例阳性、EBV—VCAIgM和（或）IgG27例阳性（P〈0．05）。诊断为非典型EBV感染的312例，其中EBVDNA阳性307例，阳性率98．4％，EBV—VCA—IgM和（或）IgG阳性137例，阳性率43．9％（P〈0．01）。结论咽拭子PCR法检测EBV—DNA敏感度高，特异度强，且取材简单，方法无创，家长易于接受，与检测EBV-VCA—IgM、IgG相比，在早期诊断EBV感染性疾病，尤其是非典型EBV感染很有应用价值。

Clinical evaluation of FQ-PCR assay for early diagnosis of EBV infection in children by testing EBV-DNA in throat washing

Objective To evaluate real-time fluorescence quantitative polymerase chain reaction（FQ-PCR） assay in testing EBV DNA in throat washing for early diagnosis of Epstein-Barr virus（EBV） infection in children. Methods Both EBV-DNA detection with FQ-PCR in throat washing and serum antibody（EBV-VCA-IgM, IgG） with ELISA assay were carried on for children with clinical diagnosis of EBV infection. The latter was to be detected again after one week if the result was negative at the first test. As control,50 healthy children were tested by both assays. Results ① Of 985 children,344 cases（34.9%） were EBVDNA positive in their throat washings, and 164 cases（16.6%） were EBV VCA IgM or IgG positive. In control group, 50 children entered the research, and only one was EBV-DNA positive, none of them was EBV-VCA-IgM or IgG positive. ② In the study cases, 38 children had infectious mononucleosis（IM）. Among them,37 children were found EBV-DNA positive,and 27 children were found VCA-IgM or IgG positive（ P d0.05） ;among 312 cases who were diagnosed atypical EBV infection, 307 cases（98.4 % ） were found EBV DNA positive and 137 cases（43.9%） were found EBV-VCA-IgM or IgG positive（ P 〈0.01）. Conclusion FQ- PCR assay in testing EBV-DNA in throat washing has high sensitivity and specificity. The samples are easy to get and have little hurt. More importantly, the assay has higher value in early diagnosing EBV infection, especially in atypical EBV infection than EBV antibody serum detection.