摘要
目的:探究血清ADA、LDH及EBV-DNA水平对传染性单核细胞增多症肝损害患儿病情及预后评估的临床价值。方法:选取109例传染性单核细胞增多症(IM)患儿为研究对象,按是否出现肝损害将患儿分为肝损害组(n=62)与非肝损害组(n=47)。检测两组患儿血清腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)水平及EB病毒脱氧核糖核酸(EBV-DNA)载量,分析不同肝损害程度上述指标表达水平及其与传染性单核细胞增多症并发肝损害的相关性,绘制ROC曲线分析上述指标的诊断效能。结果:肝损害组患儿发生肝肿大率、ALT、AST、TBil水平均高于非肝损害组(P<0.05);肝损害组患儿血清ADA、LDH及EBV-DNA水平高于非肝损害组(P<0.05),且均随肝损害程度升高而升高(P<0.05);传染性单核细胞增多症患儿血清ADA、LDH及EBV-DNA水平与ALT、AST均呈正相关(P<0.05);ROC曲线显示,血清ADA、LDH及EBV-DNA的曲线下面积(AUC)分别为0.831、0.861和0.934,截断值分别为30.60 U/L、544.63 U/L和2.35 lg copies/mL,联合诊断的AUC为0.957。结论:血清ADA、LDH及EBV-DNA水平与IM患儿肝损害相关,对于评估IM合并肝损害诊断以及预后评估方面具有一定参考价值,值得临床广泛应用。
Objective:To explore the effects of serum ADA,LDH and EBV-DNA levels on the assessment of disease condition and prognosis in children with infectious mononucleosis complicated with liver damage.Methods:109 children with infectious mononucleosis(IM)were selected as the research objects,and the children were divided into liver damage group(n=62)and non-liver damage group(n=47)according to whether they had liver damage.Serum levels of adenosine deaminase(ADA),lactate dehydrogenase(LDH)and EB virus deoxyribonucleic acid(EBV-DNA)load were detected,the differences in expression levels of the above indicators under different degrees of liver damage and their correlation with IM with liver damage were analyzed,and ROC curves were drawn to analyze the diagnostic efficiencies of the above indicators.Results:The hepatomegaly rate and levels of ALT,AST and TBil in liver damage group were higher than those in non-liver damage group(P<0.05).The levels of serum ADA,LDH and EBV-DNA were higher in liver damage group than those in non-liver damage group(P<0.05),and the above levels were increased with the increase of liver damage degree(P<0.05).Serum ADA,LDH and EBV-DNA levels were positively correlated with ALT and AST in children with IM(P<0.05).ROC curve results showed that the areas under the curves of serum ADA,LDH and EBV-DNA were 0.831,0.861 and 0.934,respectively,and their cut-off values were 30.60 U/L,544.63 U/L and 2.35 lg copies/mL.The AUC of combined diagnosis was 0.957.Conclusion:Serum ADA,LDH and EBV-DNA levels are correlated with liver damage in children with IM,and have certain reference value on the diagnosis and prognosis assessment of IM with liver damage,which is worthy of widespread clinical application.
作者
张静静
贾媛媛
胡苗苗
成胜权
ZHANG Jing-jing;JIA Yuan-yuan;HU Miao-miao;CHENG Sheng-quan(Department of Pediatrics,the First Affiliated Hospital of the Air Force Medical University,Xi'an 710032,Shaanxi,China)
出处
《川北医学院学报》
CAS
2023年第8期1090-1093,共4页
Journal of North Sichuan Medical College
作者简介
张静静(1972-),女,副主任医师。E-mail:Zhangyuqi9858@163.com;通讯作者:成胜权,博士。E-mail:quanyi@fmmu.edu.cn。
