尿巨细胞病毒定量检测在巨细胞病毒感染诊断中的意义  

Diagnosis of Cytomegalovirus Infection in Children by Quantitative Detection of Cytomegalovirus in Urine

作　　者：徐锦[1] 陈剑平[2] 丁韵珍[1] 王传华[2] 孙家娥[1] 苏犁云[1] 杨毅[1] 

机构地区：[1]复旦大学附属儿科医院 [2]中山大学达安基因股份有限公司,广州510080

出　　处：《实用儿科临床杂志》2006年第10期596-597,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨尿巨细胞病毒(CMV)定量检测在儿科CMV感染诊断中的意义。方法应用荧光定量聚合酶链反应 (FQ-PCR)方法检测110例确诊或疑诊CMV感染和81例对照患儿尿CMV-DNA,并与血清抗体检测、pp65抗原检测比较,对更昔洛韦治疗的17例病人进行治疗后尿CMV-DNA;拷贝监测。结果 1．确诊或疑诊为CMV活动性感染患儿110例,其中82例尿中检测到CMV-DNA;对照11例检测到尿CMV-DNA,其中10例为正常健康儿童;且不同年龄组CMV-DNA的阳性率不同。17 例更昔洛韦治疗后,尿CMV-DNA的平均拷贝数明显下降(P<0．001)。2．FQ-PCR、pp65、IgM检测方法敏感性分别为87％、 74％、59％,特异性分别为97％、86％、69％;与其他两种方法比较,FQ-PCR方法敏感性和特异性均明显高(P均<0.001)。结论 FQ-PCR检测尿CMV-DNA对诊断活动性CMV感染有一定意义,量化结果便于治疗过程中进行连续的监测。Objective To explore the significance of fluorescent quantitative polymerase chain reaction （FQ - PCR） assay detecting urine cytomegalovirus （CMV） - DNA to diagnose the cytomegalovirus infection in children. Methods CMV - DNA from urine was detected by FQ - PCR. Indirect immunofluorescence assay was used to detect pp65 antigen in peripheral blood leukocytes, and ELISA to detect anti - CMV IgM in serum. Seventeen patients were treated with ganciclovir and CMV - DNA copies were detected from urine after treatment. Results 1. Among 110 patients or highly suspected to be active CMV infection, 82 were positive by quantitative PCR. Among 81 controls, 11 were positive for FQ - PCR with 10 healthy children. In 17 patiens with CMV infection, after ganciclovir treatment, CMV-DNA copies significantly decreased （P 〈 0.001）. 2. The sensitivity reached 87% for FQ - PCR, 74% for pp65 and 59% for anti CMV IgM assay, respectively. The specificity of FQ - PCR was 97%, pp65 86% and anti - CMV IgM 69%, respectively. The sensitivity and specificity of FQ - PCR assay were significantly higher than those of the other two assays （all P 〈 0.001）. Conclusions Quantitative detection of CMV - DNA from urines is helpful for diagnosis of active CMV infection in pediatric patients. With the advantage of quantification this assay can be used to monitor effectiveness of therapy.

关 键 词：巨细胞病毒感染 荧光定量聚合酶链反应 儿科 

分 类 号：R450[医药卫生—治疗学]