CMV感染病儿实时荧光定量PCR检测及意义  

THE SIGNIFICANCE OF REAL TIME QUANTITATION PCR ON DIAGNOSIS AND MONITORING OF INFANT CYTOMEGALOVIRUS INFECTION

作　　者：刘薇[1] 蒋玉红[1] 孙佰秀[1] 李海峰[1] 罗兵[2] 

机构地区：[1]青岛市妇女儿童医疗保健中心检验科,山东青岛266011 [2]青岛大学医学院病原生物学教研室

出　　处：《青岛大学医学院学报》2009年第2期110-112,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨实时荧光定量PCR法检测病儿尿液中巨细胞病毒(CMV)-DNA含量在诊断和动态监测CMV感染中的意义。方法应用PE5700全自动PCR扩增分析仪,检测35例临床高度怀疑有CMV感染病儿(病儿组)尿液中的CMV-DNA拷贝数,随机选择45例同年龄段患非感染性疾病病儿作为对照组,比较两组CMV阳性标本中CMV-DNA含量,并测定治疗后的病毒载量。同时与血清CMV-IgM抗体检测结果进行比较。对部分病儿进行临床观察和随访。结果病儿组CMV感染27例,阳性检出率为77.14%;对照组CMV感染12例,阳性检出率为26.67%。治疗后两组病儿尿液中CMV-DNA拷贝数下降幅度均较大,与治疗前比较,差异有显著性(t=4.159、5.438,P<0.01)。实时荧光定量PCR法CMV阳性检出率高于血清CMV-IgM检测方法。9例病儿随访2年,1例胆管闭锁病儿手术后CMV病毒载量仍在较高水平,1年后发展为肝硬化;4例CMV肝炎经治疗后,1例CMV-DNA转阴,3例仍阳性;4例无症状性感染病儿CMV-DNA转阴或降至低水平。结论实时荧光定量PCR技术检测CMV感染具有快捷、灵敏度高、特异度高等优点,量化结果便于对治疗过程进行连续监测,为病儿治疗和随访提供有效帮助。Objective To evaluate the real-time quantitative PCR on diagnosis and monitoring of infant cytomegalovirus infection via CMV-DNA in infant urine. Methods RQ-PCR and ELISA were used to detect urine CMV-DNA in 35 infants highly suspected with CMV infection, 45 healthy infants served as controls. The contents of CMV-DNA in positive CMV specimen in two groups were compared, and a comparison with serum CMV-IgM was also made. The virus load was detected after treatment. Results The positive CMV DNA was 27 in 35 infected infants （77.14%）, and 12 in 45 healthy controls （26.67%）. After treatment, the CMV-DNA copies of two groups were both significantly decreased （t=4. 159, 5. 438;P〈0.01）. The positive rate of RQ-PCR was higher than ELISA. Nine patients were followed for two years, in which, one after surgery for biliary atresia remained CMV positive and developed hepatic cirrhosis one year later. Four patients received hepatitis therapy, one returned to negative, and three remained CMV-DNA positive. Among the four asymptomatic, the CMV negative or declined to a lower level. Conclusion RQ-PCR is rapid, sensitive, and specific in detection of CMV infection,which is easy to monitor the therapy and provide helpful information for the follow-up of the infection.

关 键 词：巨细胞病毒感染 荧光免疫测定 聚合酶链反应 

分 类 号：R725.1[医药卫生—儿科]