自体外周血CD34^+细胞移植后巨细胞病毒感染的检测  

Cytomegalovirus infection in patients undergoing autologous peripheral blood CD34^+ cell transplantation

作　　者：孙乐栋[1] 孙竞[2] 曾抗[1] 孟凡义[2] 周再高[1] 刘启发[2] 贺凤姣[1] 徐丹[2] 彭学标[1] 

机构地区：[1]南方医科大学南方医院皮肤科,广东省广州市510515 [2]南方医科大学南方医院血液科,广东省广州市510515

出　　处：《中国组织工程研究与临床康复》2009年第1期153-156,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：广东省科技计划项目(2003C32720)~~

摘　　要：背景:巨细胞病毒活动性感染,尤其是巨细胞病毒肺炎死亡率极高,并易合并细菌、真菌、原虫等感染,直接影响患者的长期存活。因此,寻找一种早期、敏感的巨细胞病毒检测方法显得特别重要。目的:探讨酶联免疫吸附法、免疫组织化学法及流式细胞仪检测在自体外周血造血干细胞移植后巨细胞病毒感染的早期诊断价值。设计、时间及地点:对比观察,病例来自2002/2005南方医科大学南方医院。对象:选择行自体外周血CD34+细胞移植的系统性红斑狼疮(16例)和天疱疮(3例)患者19例,其中男5例,女14例,年龄11~38岁。所有受试者均无糖尿病、哮喘、荨麻疹、湿疹、炎症性肠病和其他风湿病。方法:分别于移植前、移植后3,6,12,24个月进行外周血采集。主要观察指标:应用酶联免疫吸附法、免疫组织化学法及流式细胞仪检测19例接受自体外周血造血干细胞移植患者移植前、移植后3,6,12,24个月时的抗巨细胞病毒抗体及巨细胞病毒抗原。结果:19例患者均进入结果分析。血清学检测显示,全部标本抗巨细胞病毒IgG全部阳性,阳性率100%。抗巨细胞病毒IgM阳性3例,阳性率3.2%。免疫组织化学法检测巨细胞病毒抗原阳性14例,阳性率14.7%。流式细胞仪检测巨细胞病毒抗原阳性13例,阳性率13.7%。4种检测巨细胞病毒感染方法的阳性率存在显著差异(χ2=261.929,P<0.01)。结论:自体外周血造血干细胞移植后存在不同程度的巨细胞病毒感染,临床上开展流式细胞仪检测巨细胞病毒感染具有重要意义。BACKGROUND： Mortality rate of cytomegalovirus reactive infection, especially cytomegalovirus pneumonia is very high, and easily combined with infection of bacterium, fungus and protozoon. These directly affect long-term surviving of patients. As a result, to search an early sensitive cytomegalovirus detection method is necessary. OBJECTIVE： To investigate the early diagnostic value of enzyme linked immunsorbent assay, immunohistochemistry and flow cytometry to detect cytomegalovirus infection in patients after autologous peripheral blood stem cells transplantation. DESIGN, TIME AND SETTING： This is a controlled study. Cases were collected from Nanfang Hospital of Southern Medical University from 2002 to 2005. PARTICIPANTS： A total of 19 patients with systemic lupus erythematosus （n =16） and pemphigus （n=3） undergoing autologous peripheral blood CD34^＋ cell transplantation, comprising 5 males and 14 females, aged 11 38 years were enrolled. None of patients developed diabetes, asthma, urticaria, eczema, inflammatory bowel disease or other rheumatism. METHODS： Peripheral blood was collected at 3, 6, 12 and 24 months prior to and following transplantation. MAIN OUTCOME MEASURES： Cytomegalovirus antibody and antigen were detected in 19 patients undergoing autologous peripheral blood hematopoietic stem cell transplantation at 3, 6, 12 and 24 months before and after transplantation by enzyme linked immunsorbent assay, immunohistochemistry and flow cytometry. RESULTS： A total of 19 patients were included in the final analysis. The positive rate of cytomegalovirus specific IgG and IgM antibodies was 100% and 3.2%, respectively. 14 cases are positive to immunohistochemistry, resulting in the positive rate of 14.7%, and 13 cases are positive to flow cytometry, resulting in the positive rate of 13.7%, respectively. Significant differences were detected in positive rate by using the four detection method （ x^2=261.929, P 〈 0.01）. CONCLUSION： Cytomegalovirus infection is very common in the patie

关 键 词：造血干细胞 移植 巨细胞病毒 

分 类 号：R394.2[医药卫生—医学遗传学]