冯娜++薛继红

[摘要] 目的 探讨儿童巨细胞病毒感染和系统性红斑狼疮的相关性。 方法 选取于陕西省延安大学附属医院体检的60名健康儿童作为对照组，60例系统性红斑狼疮患儿作为研究组。根据使用激素和免疫抑制剂的情况，将研究组分为新发组（未使用）和稳定组（已使用）。采用酶联免疫吸附试验法检测CMV-IgM阳性率；采用魏氏自然沉降法计算患儿血沉（ESR）；补体C3应用西门子公司的BN特定蛋白分析系统（速率散射比浊法）进行检测；对系统性红斑狼疮病情活动度（SLEDAI）进行评分。 结果 研究组CMV-IgM阳性率为26.7%，明显高于对照组（3.3%），差异有统计学意义（P < 0.05）。新发组CMV-IgM阳性率为15.4%，较稳定组（47.1%）低，差异有统计学意义（P < 0.05）。CMV-IgM（+）组ESR和SLEDAI为（57.5±24.6）mm/h和（15.9±4.0）分明显高于CMV-IgM（-）组[（36.9±17.8）mm/h、（9.0±4.3）分]；而CMV-IgM（+）组C3为（0.30±0.13）g/L明显低于CMV-IgM（-）组[（0.65±0.30）g/L]，差异有统计学意义（P < 0.05）。CMV-IgM（+）组和CMV-IgM（-）组患者胃肠炎的发生率分别为31.3%和2.3%，两组肺部损害发生率分别为75.0%和11.4%，差异有统计学意义（P < 0.05）。 结论 儿童系统性红斑狼疮与巨细胞病毒感染有着密切关系，并且巨细胞病毒感染可能是儿童系统性红斑狼疮发病的重要因素之一。

[关键词] 儿童；巨细胞病毒感染；系统性红斑狼疮

[中图分类号] R593.24 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0015-03

Correlation between cytomegalovirus infection and systemic lupus erythematosus in children

FENG Na XUE Jihong

Department of Pediatrics， the Affiliated Hospital of Yan 'an University， Shaanxi Province， Yan'an 716000， China

[Abstract] Objective To explore the correlation between cytomegalovirus infection and systemic lupus erythematosus in children. Methods 60 cases of health children （control group） and 60 cases of children with systemic lupus erythematosus （study group） were selected in the Affiliated Hospital of Yan 'an University. According to the use of hormone and immune inhibitors， children in the study group were divided into the new onset group （no using） and the stable group （using）. CMV-IgM positive rate was detected by enzyme-linked immunosorbent assay； ESR was detected by Wei natural sedimentation method； complement C3 was detected by BN specific protein analysis system （rate nephelometry） of Siemens. SLEDAI was scored. Results The CMV-IgM positive rate of study group was 26.7%， which was significantly higher than that of the control group （3.3%）， with statistically significant difference （P < 0.05）. The CMV-IgM positive rate of new onset group was 15.4%， which was significantly higher than that of the stable group （47.1%）， with statistically significant difference （P < 0.05）. The ESR and SLEDAI in the CMV-IgM （+） group were （57.5±24.6） mm/h and （15.9±4.0） scores， which were significantly higher than those of the CMV-IgM （-） group [（36.9±17.8） mm/h， （9.0±4.3） scores]， with statistically significant differences （P < 0.05）； C3 in the CMV-IgM （+） group was （0.30±0.13） g/L， which was significantly lower than that of the CMV-IgM （-） group [（0.65±0.30） g/L]， with statistically significant difference （P < 0.05）. The incidence of gastroenteritis and pulmonary lesions were 31.3% and 75.0% in the CMV-IgM （+） group， which were higher than those in the CMV-IgM （-） group （2.3%， 11.4%）， with statistically significant differences （P < 0.05）. Conclusion Cytomegalovirus infection and systemic lupus erythematosus in children has closely related， and cytomegalovirus infection may be one of the important factors for systemic lupus erythematosus in children.

[Key words] Children； Cytomegalovirus infection； Systemic lupus erythematosus

系统性红斑狼疮（SLE）是一种自身免疫性疾病，会对全身多系统及多脏器造成损害，多发于青年女性，可以累及多脏器，属于自身免疫性炎症性结缔组织病，早期、轻型和不典型的病例日见增多[1]，有些重症患者（除弥漫性增生性肾小球肾炎患者外）有时亦可自行缓解，有些患者呈“一过性”发作，经过数月的短暂病程后疾病可完全消失。遗传、环境以及性激素等多种因素导致机体免疫功能紊乱是SLE发病的重要原因之一[2]。巨细胞病毒（CMV）是一种是双链DNA病毒。近年发现，CMV感染与SLE有着密切的关系，可能是导致SLE的重要因素之一[3-4]。目前SLE儿童的发病率约为6/100万，且通常儿童患病后较成人严重，预后较差[5]。本研究通过临床实例简要阐述儿童CMV感染与SLE的相互关系……