儿童噬血细胞综合征与人微小病毒B19感染的相关性及临床特征分析

目的探讨儿童噬血细胞综合征(HPS)与人微小病毒B19(HPVB19)感染可能存在的相关性,并对其临床特征进行分析。方法采用酶联免疫吸附试验(ELISA)和荧光定量PCR法对65例HPS患儿(HPS组)及65例健康体检儿童(对照组)进行HPVB19 Ig M、Ig G及HPVB19 DNA检测,并根据HPVB19DNA检测结果将HPS患儿分为HPVB19感染组(n=14)和非感染组(n=51),比较两组患儿临床资料。结果 HPS组HPVB19-Ig M阳性率(26%,17/65)显著高于对照组(9%,6/65)(P=0.011);而HPVB19-Ig G阳性率(38%,25/65)与对照组(29%,19/65)比较差异无统计学意义(P=0.266)。HPS组HPVB19感染率(22%,14/65)明显高于对照组(3%,2/65)(P=0.001)。与HPVB19非感染组HPS患儿比较,感染组患儿入院时血小板计数与血红蛋白水平显著降低,肝功能损伤更严重,发病时间更早,病程迁延时间更长(均P0.05)。结论 HPVB19感染与HPS发病可能具有相关性。HPVB19感染的HPS患儿起病更急,临床表现更为严重,病程迁延时间更长。

Clinical features of childhood hemophagocytic syndrome and its association with human parvovirus B19 infection

Objective To investigate the association of childhood hemophagocytic syndrome (HPS) with human parvovirus B19 (HPVB19) infection, and to analyze the clinical features of this disease. Methods ELISA and quantitative real-time PCR were used to detect HPVB19-IgM, HPVB19-IgG and HPVB19-DNA in 65 children with HPS (HPS group) and 65 healthy children (control group). The HPS group was divided into HPVB19-infected (n=14) and non-infected (n=51) groups according to the detection results of HPVB19-DNA. The clinical data of two groups were compared. Results The positive rate of HPVB19-IgM in the HPS group (26%, 17/65) was significantly higher than that in the control group (9%, 6/65) (P=0.011), and there was no significant difference in the positive rate of HPVB19-IgG between the HPS (38%, 25/65) and control groups (29%, 19/65) (P=0.266). The infection rate of HPVB19 in the HPS group (22%, 14/65) was significantly higher than that in the control group (3%, 2/65) (P=0.001). Compared with the noninfected group, the HPVB19-infected group had significantly lower platelet count and hemoglobin level on admission, significantly more severe liver function damage, a significantly earlier onset time, and a significantly longer course of disease (P<0.05). Conclusions The pathogenesis of HPS may be associated with HPVBl9 infection. HPVBl9-infected children with HPS have more acute onset, more severe clinical manifestations, and a longer disease duration.