巨细胞病毒检测及在异基因造血干细胞移植中应用研究  

Detection of cytomegalovirus and its clinical value in allogeneic hematopoietic stem cell transplantation

作　　者：范炜[1] 李欲航[2] 董陆佳[2] 骈淮媛[2] 卢淑娟[2] 

机构地区：[1]解放军第三五九医院检验科,江苏镇江212001 [2]军事医学科学院附属医院,北京100039

出　　处：《医学研究生学报》2001年第4期300-303,共4页Journal of Medical Postgraduates

摘　　要：目的 :探讨检测巨细胞病毒 (CMV)的方法学及在异基因造血干细胞移植 (Allo- HSCT)中临床应用的价值。　方法 :以 45例 Allo- HSCT为研究对象 ,采集移植前供者、移植前后及恢复期受者的抗凝血标本 ,分别采用 CMV-pp6 5单克隆抗体免疫组化法和 EL ISA法 ,检测 CMV早期抗原和 Ig G、Ig M抗体 ,并进行多点动态观察。　结果 :45例患者 16 3份系列标本 ,CMV早期抗原阳性 75份 ,是在移植后 6～ 2 42天首次检出 ,平均 70天 ;其中≤ 45天出现阳性者 2 6例 ,占 5 8%。术前供、受者 CMV - Ig G抗体均阳性 ,CMV - Ig M抗体供、受者各 1例阳性 ,其中受者持续阳性。术后 45例中 2 1例出现 CMV- Ig M抗体阳性 ,首次检出时间在 14～ 2 34天 ,平均 12 7天 ,比早期抗原检出时间推迟近 2个月。 45例中因 CMV感染而致间质性肺炎 2 5例 ,占 5 5 %。　结论 :异基因造血干细胞移植采用 CMVpp5 5单克隆抗体免疫组化法检测巨细胞病毒感染 ,快捷、准确、灵敏 ,对患者的诊断、治疗和预后判断有重要意义 。Objectives:To investigate the method of detecting the antigen(Ag) and antibody(Ab) of human cytomegalovirus(CMV) and its clinical value in allogeneic hematopoietic stem cell transplantation(HSCT). Methods: Forty five patients with undergoing allogeneic HSCT were studied. Anticoagulant blood samples were obtained from the donors before transplantation and from the recipients before and after transplantation and in the convalescence. The methods of monoclonal Ab immunohistochemistry and ELISA were used to examine the early stage Ag and IgG, IgM Ab of CMV, and the dynamic changes were determined. Results: Among the 163 samples of the 45 patients, 75 samples were CMV Ag positive at day 6 to day 242 after transplantation (mean time 70 days). Twenty six(58%) patients were positive in no more than 45 days. Before operation both the 45 donors and the 45 recipients were CMV IgG Ab positive. One donor was IgM Ab positive, and one recipient was IgM Ab positive in whole process. Twenty one(47%) patients became IgM Ab positive 14 to 234 days after operation (mean time 127 days which was about two months after the CMV Ag was positive). There were 25(55%) cases suffered from interstitial pneumonia(IP) caused by CMV. Conclusions: In allogeneic HSCT, the method of CMV pp65 monoclonal Ab immunhistochemistry can detect the infection of CMV earlier and faster, which is important for the clinical diagnosis, therapy, and prognosis. The technique of CMV pp65 monoclonal Ab immunohistochemistry is convenient, accurate, and sensitive. It is worthy to be popularized.

关 键 词：造血干细胞移植 巨细胞病毒 免疫组化法 PP65 

分 类 号：R446.61[医药卫生—诊断学]