基于733例择期手术患儿的EB病毒感染血清流行病学调查

目的 了解不同年龄段儿童EB病毒(EBV)感染现状及流行病学特点。方法 以首都医科大学附属北京儿童医院2010年行外科择期手术住院患儿为研究对象，并排除临床EBV感染的病例。以患儿生化检测后剩余血清，采用酶联免疫吸附法检测血清EBV-CA-IgG、EBV-NA-IgG和EBV-CA-IgM抗体。计算EBV累计感染率和新发感染率，分析各年龄组EBV感染的性别和城乡特征。结果 733例患儿进入分析，男414例，女319例。<1岁306例，~5岁193例，～10岁147例，～17岁87例。①CA-IgG、NA-IgG和CA-IgM抗体的总阳性率分别为70.4%（516例）、68.4%（501例）和0.7%（5例）；CA-IgG、NA-IgG的阳性率随年龄增长呈增高趋势；②<1、～5、～10和～17岁组EBV累计感染率分别为54.2％、74.6％、85.0％和90.8％；新发感染率分别为2.1％、2.4％、0和11.1％；③各年龄组男女性累计感染率差异无统计学意义；④各年龄组CA-IgG抗体阳性率和累计感染率均呈现城区高于郊区的趋向，但差异无统计学意义。结论 儿童EBV原发感染的年龄较早，10岁时近90%的儿童血清EBV-CA-IgG抗体阳性，年龄较20世纪80年代有所延迟。

Serological epidemiology investigation of Epstein-Barr virus infection based on 733 children to be operated

Objective To investigate the serological epidemiology of Epstein-Barr virus（ EBV） infection in children in Beijing.Methods Seven hundred and thirty three children without symptoms and signs of infection from the surgical department of Beijing Children＇s Hospital were enrolled into this study. Three antibodies against EBV including CA-IgG, NA-IgG and CA-IgM were examined by using enzyme linked immunosorbent assay（ELISA）.Results 733 children were included （414 males, 319 females）. Children in 1, -5, -10 and -17 years groups were 306, 193, 147 and 87 cases respectively. The total seropositive rate was 70.4% of CA-IgG, 68.4% of NA-IgG and 0.7% of CA-IgM respectively. The positive rates of CA-IgG and of NA-IgG were 54.2% and 51.3% in 1 year group respectively, and increased with the age. The highest positive rates of CA-IgG and NA-IgG both were 90.8% in -17 years group. The CA-IgM was only detected in five sera samples. The cumulative infection rate of EBV in 1, -5, -10 and -17 years groups were 54.2%, 74.6%, 86.4%, 90.8% and recent infection rates were 2.1%, 2.0%, 0%, 11.1%. The cumulative infection rate significantly differed between males and females in -17 years group.Conclusions The primary infection of EBV in children occurs at their childhood. The seropositive rate of EBV is about 90% at the age of 10 years in children. Compared with the age of EBV seroconversion in 1980＇s, the age has delayed with the improvement of social economic status.