尿液上皮细胞中巨细胞病毒载量预测婴儿巨细胞病毒激活感染的价值  

Prediction of infantile cytomegalovirus infection with viral load in urinary epithelial cell

作　　者：郑晓群[1] 冯晶晶[2] 林虹[2] 陈益平[3] 卢朝升[3] 吕建新[2] 

机构地区：[1]温州医学院附属第二医院实验诊断中心,325027 [2]温州医学院浙江省医学遗传学重点实验室 [3]温州医学院附属育英儿童医院感染科

出　　处：《中华检验医学杂志》2009年第4期403-406,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨尿液上皮细胞（EC）中人巨细胞病毒（HCMV）DNA载量预测婴儿活动性HCMV感染的应用价值。方法分别收集82例HCMV潜伏感染组和84例活动性感染组婴儿外周血和尿液标本，采用实时荧光定量聚合酶链反应（FQ-PCR）和化学发光免疫分析检测血浆HCMV DNA载量和HCMV IgM／IgG抗体；间接免疫荧光法检测外周血多形核白细胞（PMNLs）中HCMV pp6S抗原；UF-100尿沉渣全自动分析仪和FQ-PCR分别做尿液EC计数和HCMV DNA载量检测，并计算尿液EC中HCMV DNA载量。同时，用受试者工作特征曲线（ROC）评价尿液上皮细胞中HCMV DNA载量在婴儿HCMV激活感染诊断中的敏感度和特异度。结果166例HCMV感染婴儿尿液上皮细胞中HCMV DNA阳性检出率最高，为94．58％（157／166），病毒载量范围为5．67×10^2-1．31×10^7拷贝／10^3EC；不同时段尿液EC中HCMV DNA载量差异无统计学意义（F=0．19，P〉0．05）；活动性感染组尿液EC中HCMV DNA载量[5．13±0．99（拷贝／10^3EC，lg）]显著高于潜伏感染组[3．92±0．82（拷贝／10^3EC，lg），t=8．52，P〈0．01]；根据ROC曲线，当cut—off值为4．55时，尿液EC中HCMV DNA载量对活动性感染诊断的敏感度和特异度分别为71．4％和75．2％；活动性感染患儿更昔洛韦治疗后尿液EC中HCMV DNA载量显著低于治疗前（t=5．44，P〈0．01）。结论尿液EC中HCMV DNA载量用于预测婴儿HCMV活动性感染是一种简便、有效的方法，并能用于治疗监测。Objective To investigate the application value for predicting human cytomegalovirus （HCMV） infection with viral load in urinary epithelial cell （EC） . Methods Peripheral blood and urine specimens from 82 infants with HCMV latent infection and 84 infants with HCMV active infection were collected respectively. Plasma HCMV DNA load and the levels of HCMV IgM/IgG antibody were detected by real-time fluorescence quantitative polymerase chain reaction （FQ-PCR） and chemiluminescence y. HCMV pp65 antigen in peripheral blood polymorphonuclear leukocytes （PMNLs） was detected by indirect immunofluorescence assay. The urinary EC count and HCMV DNA load were detected by UF-100 automated urine sediment analyzer and FQ-PCR, respectively. HCMV DNA load in urinary EC was calculated accordingly. At the same time, the sensitivity and specificity for diagnosis of active HCMV infection were evaluated by receiver operating characteristic curve （ROC）. Results The positivity of HCMV DNA in urinary EC was 94. 58% （157/166） , which was the highest among the urinary EC from 166 cases of HCMV infection. HCMV DNA load ranged from 5.67 × 10^2 to 1.31× 10^7 copies/10^3 EC. There was no significantly statistical difference among urine specimens from different periods of time（ P 〉 0. 05 ）. HCMV DNA load in active infection group [5.13± 0. 99 （ copies/10^3EC, lg） ] is significantly higher than that in latent infection group [ 3.92 ± 0. 82 （ copies/10^3EC, lg）, t = 8.52, P 〈 0. 01 ] ; According to ROC curve analysis, its sensitivity and specificity were 71.4% and 75.2% respectively when cut-off value was 4. 55. The virus load was significantly decreased in urinary EC in post-treatment infants as compared with pre- treatment（t = 5. 44,P 〈 0. 01 ）. Conclusion Detection of HCMV DNA load in the urinary EC is a cost-effective method and can be used to predict HCMV active infection in infants and monitor treatment of HCMV infection.

关 键 词：巨细胞病毒感染 巨细胞病毒 DNA 病毒 尿 上皮细胞 聚合酶链反应 

分 类 号：R686[医药卫生—骨科学]