传染性单核细胞增多症患儿外周血淋巴细胞亚群分布——特征及与EB病毒载量的相关性分析

Distribution of Peripheral Blood Lymphocyte Subsets in Pediatric Patients with Infectious Mononucleosis—Characterization and Correlation Analysis with Epstein-Barr Viral Load

摘要: 目的：探讨传染性单核细胞增多症(IM)患儿外周血淋巴细胞亚群分布特征及与EB-DNA载量的相关性。方法：选取在安徽医科大学第二附属医院就诊的传染性单核细胞增多症患儿45例，依据EB-DNA载量分为低病毒载量组(<10⁵ copies/mL) 22例和高病毒载量组(≥10⁵ copies/mL) 23例。分析患儿外周血淋巴细胞亚群百分比的分布情况及与EB病毒DNA载量的相关性分析。采用受试者特征曲线(ROC)评估外周血淋巴细胞亚群对疾病转归的预测价值。结果：与低病毒载量组相比，高病毒载量组淋巴亚群CD3⁺ T细胞和CD8⁺ T细胞频率明显上升(P < 0.01, P < 0.001)；CD4⁺ T细胞、CD19⁺B细胞和调节性T细胞(Treg)频率及CD4⁺/CD8⁺比值显著降低(P < 0.01, P < 0.05, P < 0.05, P < 0.01)；CD3-CD16⁺CD56⁺NK细胞频率则无显著性差异(P > 0.05)。Pearson相关性分析结果显示CD3⁺ T细胞和CD8⁺ T细胞频率均与EB-DNA载量呈正相关(P < 0.001, P < 0.001)；CD4⁺ T细胞频率、CD19⁺ B细胞频率、Treg细胞频率及CD4⁺/CD8⁺比值与EB-DNA载量呈负相关(P < 0.001, P < 0.001, P < 0.01, P < 0.001)。ROC曲线分析表明CD3⁺ T细胞、CD4⁺ T细胞、CD8⁺ T细胞频率和Treg细胞频率以及CD4⁺/CD8⁺比值均具有较好的预测疾病转归的价值。结论：传染性单核细胞增多症患儿外周血CD3⁺ T细胞频率和CD8⁺ T细胞频率与EB-DNA载量呈正相关；CD4⁺ T细胞频率、CD19⁺ B细胞频率、Treg细胞频率和CD4⁺/CD8⁺比值与EB-DNA载量呈负相关，对预测疾病转归具有较好的临床意义。

Abstract: Objective: To investigate the distribution characteristics of peripheral blood lymphocyte subsets and their correlation with Epstein-Barr virus DNA (EB-DNA) load in children with infectious mononucleosis (IM). Methods: A total of 45 children with IM who were treated in the Second Affiliated Hospital of Anhui Medical University were enrolled. According to the EB-DNA load, they were divided into the low viral load group (<10⁵ copies/mL, n = 22) and the high viral load group (≥10⁵ copies/mL, n = 23). The distribution of peripheral blood lymphocyte subset percentages and their correlation with EB-DNA load were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of peripheral blood lymphocyte subsets for disease outcome. Results: Compared with the low viral load group, the high viral load group showed significantly increased frequencies of CD3⁺ T cells and CD8⁺ T cells (P < 0.01, P < 0.001); significantly decreased frequencies of CD4⁺ T cells, CD19⁺ B cells, and regulatory T cells (Treg), as well as a significantly reduced CD4⁺/CD8⁺ ratio (P < 0.01, P < 0.05, P < 0.05, P < 0.01); while no significant difference was observed in the frequency of CD3⁻CD16⁺CD56⁺ natural killer (NK) cells (P > 0.05). Pearson correlation analysis revealed that the frequencies of CD3⁺ T cells and CD8⁺ T cells were positively correlated with EB-DNA load (P < 0.001, P < 0.001); the frequencies of CD4⁺ T cells, CD19⁺ B cells, and Treg cells, as well as the CD4⁺/CD8⁺ ratio, were negatively correlated with EB-DNA load (P < 0.001, P < 0.001, P < 0.01, P < 0.001). ROC curve analysis indicated that the frequencies of CD3⁺ T cells, CD4⁺ T cells, CD8⁺ T cells, and Treg cells, as well as the CD4⁺/CD8⁺ ratio, all had good value in predicting disease outcome.Conclusion: In children with IM, the frequencies of peripheral blood CD3⁺ T cells and CD8⁺ T cells are positively correlated with EB-DNA load; the frequencies of CD4⁺ T cells, CD19⁺ B cells, and Treg cells, as well as the CD4⁺/CD8⁺ ratio, are negatively correlated with EB-DNA load, which have good clinical significance for predicting disease outcome.