造血干细胞移植后对人巨细胞病毒感染病毒载量的检测  

Application of real-time quantitative PCR for guidance therapy of cytomegalovirus infection after allohematopoietic stem cell transplantation

作　　者：张晓艳[1] 李建勇[1] 吴汉新[1] 戎国栋[2] 钱思轩[1] 张卫[3] 黄佩珺[3] 洪鸣[1] 张闰[1] 

机构地区：[1]南京医科大学第一附属医院血液科,210029 [2]南京医科大学第一附属医院 检验科,210029 [3]南京医科大学第一附属医院 检验科,210029

出　　处：《中华传染病杂志》2006年第6期401-405,共5页Chinese Journal of Infectious Diseases

基　　金：江苏省自然科学基金重大招标项目(BK2004004);江苏省社会发展资助项目(BS2003043);江苏省卫生厅资助项目(H200313)

摘　　要：目的探讨应用实时定量聚合酶链反应(RQ-PCR)法对异基因造血干细胞移植(allo- HSCT)后巨细胞病毒(CMV)感染的诊断价值及对临床用药的指导意义。方法33例行allo-HSCT、的患者于造血重建后,应用RQ-PCR法对其外周血CMV DNA进行动态检测,根据检测结果决定抗CMV治疗的开始、减量和终止,观察治疗效果和临床转归。结果共检出13例CMV感染患者,21次感染发作；除1次是患者中途放弃治疗外,余20次治疗中CMV DNA拷贝迅速转阴或下降至转阴,有临床表现者症状消失、器官功能恢复；且抗CMV疗程短于常规疗程。结论应用RQ-PCR法不但可以早期诊断CMV感染,及时干预治疗,还可以直观指导治疗的减量和终止、缩短疗程、减轻药物不良反应。Objective To discuss the significance of the application of real-time quantitative PCR（RQ-PCR） for diagnosis and guidance therapy of cytomegalovirus （CMV） infection after allohematopoietic stem cell transplantation（allo-HSCT）. Methods Thirty three patients were undergo ing allo-HSCT. After hematopoietic reconstitution, patients＇peripheral blood samples were detected for CMV DNA by RQ-PCR periodically. Anti-viral therapy was begun, attenuated and stopped according to the results of CMV DNA detection. The effects of anti-viral therapy and patients＇ clinical results were observed. Results CMV DNA was detected in blood samples from 13 of 33 patients. There were 21 episodes in these patients. Only 1 episode wasn＇t controlled because the patient gave up the therapy. CMV DNA copies were disappeared soon or decreased and then disappeared during anti-viral therapy in the others＇. Patients which had symptoms and/or dysfunction of organs were cured too. Each course of anti-viral therapy was shorter than ordinary course. Conclusions CMV infection can be diagnosed as early as possible by RQPCR. To begin, attenuate and stop anti-viral therapy according to the results of RQ-PCR is safe. The course is shortened and the side effects of anti-viral drugs were attenuated .

关 键 词：巨细胞病毒感染 实时聚合酶链反应 造血干细胞移植 病毒载量 

分 类 号：R457.7[医药卫生—治疗学] R512.99[医药卫生—临床医学]