基于核酸序列的扩增技术在异基因外周血干细胞移植后受者HCMV感染诊断的应用  

Application of Nucleic Acid Sequence-Based Amplification in Detection of Cytomegalovirus mRNA of Recipients after Allogeneic Peripheral Blood Stem Cell Transplantation

作　　者：徐鸿绪[1] 刘雅峰[1] 谭恩勋[2] 蔡建涛[3] 

机构地区：[1]中山大学附属第一医院器官移植实验室,广州510080 [2]中山大学附属第一医院血液内科,广州510080 [3]广东省人民医院血液内科,广州510080

出　　处：《中国实验血液学杂志》2006年第6期1195-1199,共5页Journal of Experimental Hematology

摘　　要：本研究探讨基于核酸序列的扩增技术(nucleicacidsequencebasedamplification,NASBA)检测mRNA对异基因外周血干细胞移植受者术后人类巨细胞病毒(HCMV)感染的诊断价值,并评价该技术对抗病毒治疗的指导意义。以128例移植术后患者为研究对象,采集移植术后外周血352份;利用NASBA检测外周血中HCMV基质外壳蛋白PP67(UL65)mRNA,并与HCMVDNA的结果进行比较。结果表明352份血标本中,HCMVmRNA阳性105份(29.83%),HCMVDNA阳性183份(51.99%)。128例患者术后有45例发展为HCMV病,HCMVDNA和HCMVmRNA检测诊断HCMV病的敏感性和特异性分别为95.56%(43/45)、93.33%(42/45)和60.24%(50/83)、97.59%(81/83)。两者特异性的比较差异具有显著性(P<0.05)。结论HCMV-PP67的NASBA检测方法具有快速、敏感性高和特异性强等优点,可作为快速检测HCMV病的方法用于临床。该法检测结果与移植受者的临床症状相关,故也可用作监视异基因造血干细胞移植受者术后HCMV感染和指导抗病毒治疗的依据。The study was purposed to investigate diagnostic value of late-mRNA detection by nucleic acid sequence-based amplification （NASBA） technique for human cytomegalovirus （HCMV） infection of the recipients after allogeneic peripheral blood stem cell transplantation （allo-PBSCT） and to evaluate the clinical significance for guiding antiviral therapy. 352 samples were collected from 128 transplant patients after allo-PBSCT. A molecular biological diagnostic technique -NASBA was used to detect human cytomegalovirus （HCMV） late mRNA encoding the viral structural protein PP67 （ UL65 ） expression in peripheral blood of recipients after allo-PBSCT, and the detected results were compared with HCMV DNA detection by PCR. The sensitivity, specificity and early diagnostic value of HCMV mRNA detection for HCMV disease were evaluated. The results showed that out of 352 detected blood specimens from 84 patients 183 specimens （51.99%） were positive of HCMV DNA by PCR, 105 specimens （29.83 % ） were positive of HCMV mRNA by NASBA. 45 patients were infected by HCMV. The sensitivity and specificity of HCMV DNA and HCMV mRNA for detecting HCMV disease were 95.56% （43/45） ,93.33% （42/45） and 60.24% （50/83） ,97.59% （81/83）. The results of specificity showed significant difference between two groups of HCMV mRNA and HCMV DNA（P 〈0.05 ）. It is concluded that the detection of late-mRNA of HCMV by NASBA technique is rapid, sensitive and specific aetection for HCMV active infection. The detected result correlates with clinical symptoms. It can monitor HCMV infection of allo-PBSCT transplanted recipients and provide indication to antiviral therapy.

关 键 词：异基因外周血干细胞移植 人类巨细胞病毒感染 基于核酸序列的扩增技术 

分 类 号：R457.7[医药卫生—治疗学] R373.2[医药卫生—临床医学]