EBV特异性抗体再激活与EB病毒感染患儿肝功能损害的关联度分析

摘要/Abstract

摘要： 目的探讨EBV特异性抗体再激活患儿与原发EB病毒感染患儿的临床资料、肝功能指标以及免疫指标,并分析其关联度。方法选取2019年5月至2023年5月期间首都医科大学附属北京儿童医院保定医院收治的209例EBV-DNA阳性患儿作为研究对象,根据特异性抗体检验结果分为原发性EBV感染组(n=144)和再激活性EBV感染组(n=65)。分析两组患儿的临床资料、肝功能以及免疫指标。采用Pearson相关性分析对肝功能指标与免疫指标的关联度进行分析。结果原发组患儿在肝肿大、脾肿大、淋巴结炎、眼睑水肿等临床症状的发生率均高于再激活组(P<0.05)。再激活组患儿在血液系统、神经系统、多浆膜积液等并发症的发生率方面均高于原发组(P<0.05)。在再激活组中,患儿的ALT、AST、DBil水平均较原发组显著升高[分别为139.22(44.18,654.59)比123.64(49.25,339.11)、148.93(61.57,663.85)比98.73(59.50,262.66)、2.87(1.19,33.12)比1.85(1.11,5.53),均P<0.05]。再激活组中,患儿的CD8⁺显著下降[27.85(12.45,63.20)比61.72(37.59,75.88)],CD4/CD8和CD20⁺较原发组显著升高[分别为1.07(0.18,2.32)比0.25(0.13,0.54),10.02(1.92,31.12)比4.63(1.88,10.30),P<0.05]。采用Pearson相关性分析,ALT、AST、DBil与CD8⁺存在负相关,与CD4/CD8、CD20⁺存在正相关(P均＜0.05)。结论 EBV再激活患儿在临床资料、肝功能和免疫指标方面表现出显著差异,提示EBV特异性抗体再激活与肝功能损害和免疫反应密切相关。

关键词: EB病毒, 肝功能损害, EBV特异性抗体, 儿童, 免疫

Abstract: Objective To investigate the clinical data, liver function indicators, and immune markers of children with reactivated EBV-specific antibodies compared to those with primary EBV infections, and to analyze their correlation. Methods From May 2019 to May 2023, 209 children with positive EBV-DNA were admitted to Beijing Children′s Hospital Baoding Hospital, affiliated with Capital Medical University. Based on the results of specific antibody tests, they were divided into two groups: a primary EBV infection group (n=144) and a reactivated EBV infection group (n=65). The clinical data, liver function indicators, and immune markers of the two groups were analyzed. Pearson correlation analysis was employed to assess the association between liver function indicators and immune markers. Results Children in the primary group exhibited a higher incidence of hepatomegaly, splenomegaly, lymphadenitis, and eyelid edema (P<0.05). The reactivation group had a higher incidence of complications in the hematological system, nervous system, and serous effusions (P<0.05). In the reactivated group, ALT levels were 139.22 (range 44.18 to 654.59) compared to 123.64 (range 49.25 to 339.11), AST levels were 148.93 (range 61.57 to 663.85) compared to 98.73 (range 59.50 to 262.66), and DBil levels were 2.87 (range 1.19 to 33.12) compared to 1.85 (range 1.11 to 5.53) in the primary group, all showing statistical significance (P<0.05). For immune markers, CD8⁺ was lower at 27.85 (range 12.45 to 63.20) compared to 61.72 (range 37.59 to 75.88), CD4/CD8 was 1.07 (range 0.18 to 2.32) compared to 0.25 (range 0.13 to 0.54), and CD20⁺ was 10.02 (range 1.92 to 31.12) compared to 4.63 (range 1.88 to 10.30) in the primary group, with significant differences (P<0.05). Pearson correlation analysis showed that ALT, AST, and DBil had a negative correlation with CD8⁺ and a positive correlation with CD4/CD8 and CD20⁺ (P<0.05). Conclusion Children with reactivated EBV exhibit significant differences in clinical data, liver function, and immune markers, indicating a close association between EBV-specific antibody reactivation, liver function damage, and immune response.

Key words: EBV, Liver function damage, EBV-specific antibodies, Children, Immunity

王慧, 郭欣, 夏明倩, 李晨曦, 崔红超. EBV特异性抗体再激活与EB病毒感染患儿肝功能损害的关联度分析[J]. 肝脏, 2025, 30(5): 700-704.

WANG Hui, GUO Xin, XIA Ming-qian, LI Chen-xi, CUI Hong-chao. Analysis of the association between EBV-specific antibody reactivation and liver function damage in children infected with EBV[J]. Chinese Hepatolgy, 2025, 30(5): 700-704.

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