巨细胞病毒性肝炎患儿治疗前后CMV-PP65抗原表达变化  

The expression change of CMV-PP65 antigen in infants with cytomegalovirus hepatitis before and after treatment

作　　者：宁岚英[1] 张艳丽[2] 徐俊杰[3] 王晓菲[4] 

机构地区：[1]济南军区司令部第四干休所,250022 [2]济南军区司令部门诊部 [3]山东大学齐鲁儿童医院消化科 [4]济南军区联勤部门诊部

出　　处：《中华消化病与影像杂志（电子版）》2012年第5期23-26,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨巨细胞病毒性肝炎患儿CMV-PP65抗原检测的临床意义。方法选择2009年1月至2010年6月于济南军区司令部第四干休所住院且临床检查有黄疸、肝大等体征的86例巨细胞病毒性肝炎患儿,入院时、治疗结束时均采用全自动生化分析仪检测患儿外周血的肝生化指标,包括总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(GPT)、谷草转氨酶(GOT)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)等;采用酶联免疫吸附测定法检测患儿CMV-IgM抗体水平;采用间接免疫荧光法检测患儿CMV-PP65抗原水平。结果经抗病毒治疗后,巨细胞病毒性肝炎患儿TBIL、DBIL、GPT、GOT、GGT、ALP较治疗前均有不同程度降低[(45±27)μmol/L与(132±65)μmol/L,(38±24)μmol/L与(97±52)μmol/L,(72±27)U/L与(126±51)U/L,(53±14)U/L与(86±22)U/L,(117±67)U/L与(149±104)U/L,(420±151)U/L与(432±167)U/L比较],且TBIL、DBIL、GPT、GOT、GGT差异均有统计学意义(t=10.94,9.43,10.07,12.56,2.80;均P<0.05),而ALP差异无统计学意义(t=1.71,P>0.05);治疗后巨细胞病毒性肝炎患儿CMV-IgM阳性表达率与治疗前比较差异无统计学意义[73.3%(63/86)与66.3%(55/86)比较,χ2=1.33,P>0.05],而CMV-PP65抗原阳性表达率较治疗前降低,且差异有统计学意义[27.9%(24/86)与90.7%(78/86)比较,χ2=10.87,P<0.05]。结论在巨细胞病毒性肝炎患儿治疗中,CMV-PP65抗原检测具有临床意义。Objective To observe the expression chang of CMV-PP65 antigen in infants with cytomegalovirus hepatitis before and after treatment,and to discuss the clinical significance of CMV-PP65 antigen detection. Methods Eighty cases of infants with cytomegalovirus hepatitis were collected in No. 4 Sanatorium in Jinan Military Region Queshan Headquarters from January 2009 to June 2010, accompanying by icterus and hepatomegaly. At admission and at discharge, automatic biochemical analyzer was used to detect liver biochemical indicators including total bilirubin （ TBIL）, direct bilirubin （ DBIL）, glutamic-pyruvic transaminase （ GPT）, glutamic-oxalacetic transaminease （ GOT）, glutamyltranspeptidase （ GGT）, and alkaline phosphatase （ALP） . ELISA method was used to detect the level of CMV IgM antibody, and CMV IgM antigen was detected by indirect immunofluorescence technique. Results After treatment of antiviral, the level of TBIL, DBIL, GPT, GOT, GGT and ALP of the infants were reduced in different degrees, and there were significantly differences in TBIL, DBIL, GPT, GOT and GGT （ t = 10.94,9.43,10.07,12.56,2.80, all P 〈 0.05 ）, but not for ALP （ t = 1.71 ,P 〉 0.05 ）. After treatment, the positive expression rate of CMV IgM was increased as compared with pretreatment [ 73.3 % （63/86） vs 66.3 % （55/86） ,χ2 = 1.33, P 〉 0.05 ] , while the positive expression rate of CMV PP65 antigen was significantly decreased as compared with pretreatment [ 27.9% （24/86） vs 90.7% （78/86）, χ2 = 10.87, P 〈 0.05 ]. Conclusion It is clinical significant to detect CMV PP65 antigen in treatment of cytomegalovirus hepatitis.

关 键 词：肝炎 病毒性 人 巨细胞病毒 抗原 病毒 

分 类 号：R725.1[医药卫生—儿科]