巨细胞病毒原发感染与非原发感染的鉴别诊断方法  

Differential diagnosis between primary cytomegalovirus infection from non-primary infection

作　　者：牛向兰 侯林浦[2] 谷学英 李欣[2] 马旭[2] 

机构地区：[1]深圳市人口和计划生育科学研究所优生遗传实验中心,广东518048 [2]国家人口计生委科学技术研究所优生遗传室

出　　处：《中国生育健康杂志》2008年第2期95-98,100,共5页Chinese Journal of Reproductive Health

摘　　要：目的建立一种快速、简便和实用的测定巨细胞病毒IgG抗体亲和指数的方法,作为有效的诊断工具,用于区分孕妇巨细胞病毒近期原发与非原发感染(继发、再感染及持续感染)。方法用标准的间接ELISA技术测定巨细胞病毒IgG抗体亲和指数(CMV-IgGAI),以35mmol/L浓度的二乙胺(温和蛋白变性剂)作为洗脱液。结果通过比较4种温和蛋白变性剂对检测方法各个环节的影响,确定了检测方法的最佳工艺流程;对127份血清标本进行了检测,其中84例为既往感染标本、17例继发感染标本、15例可疑原发感染和11例原发感染标本,以CMV-IgGAI<40.0%作为诊断CMV原发感染的临界值,其方法的灵敏度为72.7%,特异性为98.8%,方法的可用度为73.5%。结论用35.0mmol/L浓度的二乙胺洗脱1次,10min的方法适用于CMV-IgGAI的测定,目前认为该测定联合CMV-IgM检测是区分原发与非原发CMV感染的最佳血清学方法之一。Objective To establish a rapid, easy and convenient method for the determination of cytomegalovirus specific immunoglobulin G antibodies avidity index （CMV -IgG AI） as an effective diagnostic tool to distinguish recent primary CMV infection from non - primary infection （ secondary infection, reinfection or persistence infection ） in pregnant women. Method The measurement of CMV - IgG AI was performed by standard indirect ELISA method using 35mM diethyl amine （a wild protein denaturing agent） as washing solution. Results A comparison of four wild protein denaturing agent for the measurement of CMV-IgG AI was carried out. A technical research of differential assay stage of the method for detected CMV - IgG AI was accomplished. The best technical flow was defined. A total of 127 cases were tested. 84 cases were considered as past infection, 17 cases as secondary infection, 15 cases as suspicious primary in- fection, and 11 cases as primary infection. When CMV - IgG AI less than 40.0 % was defined as positive of recent primary CMV infection, the sensitivity and specificity of differentiating primary from non-primary CMV infection were 72. 7 % and 98. 8 %, respectively. The applicability of the method was 73.5 %. Conclusion The procedures of using 35mM diethyl amine solution and washing once for 10 mins is consid- ered suitable for determination CMV - IgG AI. At present, the combination of CMV - IgG AI and CMV - IgM assay seems to be one of the best serological test for differentiating primary from non - primary CMV in-fection.

关 键 词：巨细胞病毒 亲和指数 IGG抗体 原发感染 酶联免疫吸附试验 

分 类 号：R725.1[医药卫生—儿科]