河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (4): 470-473,486.doi: 10.3969/j.issn.1007-3205.2021.04.021

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血清TNF-α、SAA、ADA对儿童EBV相关传染性单核细胞增多症的诊断价值研究

  

  1. 1.河北省盐山县人民医院检验科，河北 盐山 061300；2.河北省高碑店市医院检验科，河北 高碑店 074000
  • 出版日期:2021-04-25 发布日期:2021-04-29
  • 作者简介:刘文田（1977-），男，河北沧州人，河北省盐山县人民医院副主任检验技师，医学学士，从事临床检验研究。
  • 基金资助:
    沧州市重点研发计划指导项目（192106016）

Study on the diagnostic value of serum TNF-α, SAA and ADA in children with EBV-related infectious mononucleosis

  1. 1.Department of Laboratory Medicine, People′s Hospital of Yanshan County, Hebei Province, Yanshan
    061300, China; 2.Department of Laboratory Laboratory Medicine, Gaobeidian Hospital, 
    Hebei Province, Gaobeidian 074000, China
  • Online:2021-04-25 Published:2021-04-29

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摘要： 目的  探讨血清肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、淀粉样蛋白A(serum amyloid A，SAA)、腺苷脱氨酶（adenosine deaminase，ADA）诊断儿童EBV相关传染性单核细胞增多症（infectious mononucleosis，IM）的价值。
方法  选择EBV相关IM患儿201例（感染组）和健康儿童200例（对照组），检测血清TNF-α、SAA、ADA水平，分析TNF-α、SAA、ADA与EBV相关IM患儿血常规、生化指标、异型淋巴细胞计数、EB病毒脱氧核糖核酸（epstein-barrvirus deoxyribonucleic acid，EBV-DNA）拷贝数之间相关性。受试者工作特征曲线（Receiver operator characteristics curve，ROC）分析TNF-α、SAA、ADA诊断EBV相关IM的价值。
结果  感染组血清TNF-α、SAA、ADA水平均高于对照组（P＜0.05），TNF-α、SAA、ADA水平均与淋巴细胞、异型淋巴细胞、EBV-DNA、ALT呈正相关（P＜0.05）。ROC分析结果显示TNF-α、SAA、ADA诊断EBV相关IM的曲线下面积（AUC）分别为0.752、0.787、0.788、0.931，敏感度分别为70.65%、77.61%、76.12%、92.04%，特异度分别为76.50%、82.00%、84.50%、96.00%。
结论  EBV相关IM患儿血清TNF-α、SAA、ADA水平明显升高，其水平与异型淋巴细胞、EBV-DNA拷贝数、肝功能具有密切相关性。联合TNF-α、SAA、ADA可提高EBV相关IM诊断的准确率。


关键词: 传染性单核细胞增多症, TNF-α, SAA, ADA

Abstract: Objective  To investigate the value of serum tumor necrosis factor-α（TNF-α）, serum amyloid A(SAA) and adenosine deaminase(ADA) in the diagnosis of EBV-related infectious mononucleosis(IM) in children. 
Methods  A total of 201 children with EBV-related IM (infection group) and 200 healthy children (control group) were selected. The serum levels of TNF-α, SAA and ADA were measured, and the correlation between TNF-α, SAA, ADA and blood routine, biochemical indexes, heteromorphic lymphocyte, epstein-barrvirus deoxyribonucleic acid(EBV-DNA) copy number in EBV-related IM of children was analyzed. Receiver operator characteristics curve (ROC) was used to analyze the value of TNF-α, SAA and ADA in the diagnosis of EBV-related IM. 
Results  The serum levels of TNF-α, SAA and ADA in the infection group were higher than those in the control group(P＜0.05). The levels of TNF-α, SAA and ADA were positively correlated with lymphocytes, heteromorphic lymphocyte, EBV-DNA copy number and ALT(P＜0.05). ROC analysis showed that the area under the ROC(AUC) of TNF-α, SAA and ADA in the diagnosis of EBV-related IM was 0.752, 0.787, 0.788 and 0.931, respectively; the sensitivity was 70.65%, 77.61%, 76.12% and 92.04%, respectively, and the specificity was 76.50%, 82.00%, 84.50% and 96.00%, respectively. 
Conclusion  The serum levels of TNF-α, SAA and ADA in EBV-related IM children are significantly higher, which are closely related to the levels of heteromorphic lymphocyte, EBV-DNA copy number and liver function. Combined detection of TNF-α, SAA and ADA can improve the accuracy of EBV-related IM diagnosis.


Key words: infectious mononucleosis, TNF-α, SAA, ADA

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