HCMV pp65抗原血症和UL83基因检测对肾移植术后HCMV感染的诊断价值  

Comparison of pp65 antigenemia assay and polymerase chain reaction for UL83 DNA for detection of HCMV in renal transplant patients

作　　者：谢栋栋[1] 林政[2] 施浩强[3] 吴琼[4] 王明丽[4] 陈磊[1] 唐亮[3] 廖贵益[3] 于德新[3] 

机构地区：[1]安徽医科大学第二附属医院泌尿外科,合肥230601 [2]武警安徽省总队医院泌尿外科,合肥230041 [3]安徽医科大学第一附属医院泌尿外科,合肥230022 [4]安徽医科大学微生物学教研室,合肥230032

出　　处：《安徽医科大学学报》2011年第9期950-952,981,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽医科大学科研基金项目(编号:2008kj17)

摘　　要：目的探讨外周血白细胞人巨细胞病毒(HCMV)pp65抗原血症检测和UL83基因检测对肾移植术后HCMV感染的诊断价值和临床意义。方法对77例肾移植受者术后定期随访患者外周血进行HCMV感染检测,分别进行外周血白细胞HCMV pp65抗原血症实验和PCR技术检测HC-MV UL83基因,比较两种方法的诊断准确性。结果 77例肾移植患者中HCMV pp65抗原血症阳性者13例,阳性率为16.9%;PCR法检测HCMV UL83基因阳性者15例,阳性率为19.5%。其中16例临床诊断为HCMV感染,其中7例为症状性感染,9例为无症状性感染。阳性符合率75%,阴性符合率94%。HCMV pp65检测的阳性率与PCR检测的阳性率比较,Kappa值为0.826(>0.75),差异有显著性(P<0.01),说明两种方法检测结果一致性较好。结论外周血白细胞pp65抗原血症实验和PCR技术的联合应用对监测HCMV活动性感染、临床疗效及预后更加客观、准确。Objective To compare the results obtained using HCMV pp65 antigenemia assay and polymerase chain reaction for detecting HCMV UL83 DNA on the peripheral blood leukocytes which collected from recipients after kidney transplantation.Methods HCMV pp65 antigenemia assay and polymerase chain reaction were respectively used for detecting HCMV UL83 DNA on the peripheral blood leukocytes which collected from recipients of whom regularly follow-up after renal transplantation.Results There were 13 samples positive for pp65 antigenemia assay in the 77 patients,and the positive rate was 16.9%.There were 15 samples positive for polymerase chain reaction of detecting HCMV UL83 DNA,and the positive rate was 19.5%.Among 77 patients,there were 16 patients diagnosed cytomegalovirus infection in clinical,seven of whom were symptomatic.The concordance between PCR and pp65 antigenemia assay was 94%.The positive concordance was 75%,and the negative concordance was 94%.Conclusion It is more accurate and objective to use pp65 antigenemia assay and polymerase chain reaction together to monitor active cytomegalovirus infection and the curative effect.

关 键 词：巨细胞病毒 巨细胞病毒感染/诊断 肾移植 聚合酶链反应 

分 类 号：R692[医药卫生—泌尿科学] R617[医药卫生—外科学]