背景:EB病毒相关淋巴增殖性疾病(EBV-LPDs)是一组涉及淋巴组织或淋巴细胞的疾病。中国住院儿童EBV-LPDs的流行病学和经济负担尚未得到很好的研究。本研究旨在揭示中国住院儿童EBV-LPDs的流行特征和疾病负担。为预防和管理提供策略。
方法:本研究基于中国FUTang更新医疗协议(FUTURE)数据库,收集了2016年1月至2021年12月中国27家三级儿童医院的医疗记录。计算五种类型的EBV-LPD,即EBV阳性T细胞淋巴增殖性疾病,NK/T细胞淋巴瘤,结外NK/T细胞淋巴瘤(鼻型),儿童系统性EBV阳性T细胞淋巴增殖性疾病和移植后淋巴增殖性疾病。我们对其流行病学特征进行了回顾性综合分析,费用,停留时间(LOS)以及诊断为五种EBV-LPDs的住院儿童的并发症,并使用适当的统计检验比较参数。
结果:该研究描述了2016年至2021年期间因EBV-LPDs住院的153名0-18岁儿童。男女比例为1.10:1,年龄分布的一半以上在6-12y组中。在EBV-LPDs病例中,EBV+T-LPD所占比例最大(65.36%)。93例EBV-LPDs患儿出现并发症,主要为噬血细胞淋巴组织细胞增生症(HLH)。NKTL的LOS中位数为26.5天[四分位距(IQR)=3-42],这是EBV-LPDs中最长的。PTLD的平均住院费用为10785.74美元(IQR=7329.38-16531.18),这是EBV-LPDs中最重的。
结论:与同期和同年龄组的中国住院儿童总数相比,EBV-LPD的比例很低。EBV-LPD可以在所有年龄段发展,但在学龄儿童中更为常见。在5个EBV-LPD中,比例最高的疾病是EBV+T-LPD。EBV-LPD的总体疾病负担很重,尤其是经济负担。HLH是最常见的并发症之一,这可能会直接影响患者的负担,因为长期住院。这些数据来自一个非常大的数据库,说明了中国EBV-LPDs住院儿童的流行病学和经济负担,丰富了现有EBV-LPDs的流行病学和疾病负担内容。
BACKGROUND: Epstein-Barr virus-associated lymphoproliferative disorders (EBV-LPDs) are a group of disorders involving lymphoid tissues or lymphocytes. The epidemiology and economic burden of hospitalized children with EBV-LPDs in
China have not been well studied. This study aimed to reveal the epidemic characteristics and disease burden of EBV-LPDs among the Chinese hospitalized children, providing strategies for the prevention and management.
METHODS: This study was based on the FUTang Updating medical REcords (FUTURE) database of
China and collected the medical records from 27 tertiary children\'s hospitals between January 2016 and December 2021 in
China, counting five types of EBV-LPDs, namely EBV-positive T-cell lymphoproliferative disease, NK/T cell lymphoma, extranodal NK/T-cell lymphoma (nasal type), systemic EBV-positive T-cell lymphoproliferative disease of childhood and posttransplant lymphoproliferative disorders. We conducted a retrospective syhthesis and analysis of the epidemiological characteristics, expenses, length of stay (LOS), as well as complications among hospitalized children diagnosed with five types of EBV-LPDs and compared parameters using appropriate statistical tests.
RESULTS: The study described 153 children aged 0-18 years hospitalized with EBV-LPDs from 2016 to 2021 in the FUTURE database. The male-to-female ratio was 1.10:1, and more than half of the age distribution was in the 6-12 y group. Among EBV-LPDs cases, EBV+ T-LPD accounted for the largest proportion (65.36%). Complications were presented in 93 children with EBV-LPDs, mainly hemophagocytic lymphohistiocytosis (HLH). The median LOS of NKTL was 26.5 days [interquartile range (IQR) = 3-42], which was the longest among EBV-LPDs. The median hospitalization cost of PTLD was 10 785.74 United States dollars (IQR = 7 329.38-16 531.18), which was the heaviest among EBV-LPDs.
CONCLUSIONS: Compared with the total number of hospitalized children in
China during the same period and in the same age group, the proportion of EBV-LPD is very low. EBV-LPD can develop in all age groups, but it is more common in school-age children. Among 5 EBV-LPDs, the disease with the highest proportion is EBV+ T-LPD. The overall disease burden of EBV-LPD was heavy, especially the economic burden. HLH was one of the most common complications, which could directly affect the burden of patients because of prolonged hospitalization. These data are taken from a very large database, illustrating the epidemiological and economic burden of EBV-LPDs hospitalized children in
China, which enriched the existing epidemiological and disease burden content of EBV-LPDs.