异基因造血干细胞移植后巨细胞病毒感染监测的临床价值  

Clinical value of the detection of cytomegalovirus DNA in HSCT recipients

作　　者：金欣[1] 佟利威 许晓跃[1] 吴海涵[1] 袁方[1] 姜雪丹[1] 李占甲[1] 于农[1] 

机构地区：[1]军事医学科学院附属医院检验科,北京100071

出　　处：《分子诊断与治疗杂志》2014年第2期79-82,共4页Journal of Molecular Diagnostics and Therapy

基　　金：国家高技术研究发展计划子课题(863计划)(2011AA02A109)

摘　　要：目的探讨异基因造血干细胞移植患者巨细胞病毒感染的临床价值，评价其CMV感染与CMV病的关系并观察抗病毒疗效。方法用实时荧光定量PCR方法动态监测CMV-DNA拷贝数的变化。结果异基因造血干细胞移植患者115例，其中有32例患者出现1～3次血CMV阳性，占27．83％（32／115）。32例阳性患者中4例发生CMV病，占12．5％。血CMV阳性者32例中有25例合并细菌或真菌感染，占78．13％（25／32）。血CMV阳性患者中，28．13％（9／32）出现移植后继发造血抑制，83例血CMV阴性患者中，18．07％（15／83）出现继发造血抑制，发生率的差异无统计学意义。单独应用更昔洛韦为主治疗的15例，13例CMV检测转阴，占86．67％。单独应用膦甲酸钠为主治疗的患者5例，CMV检测转阴4例。结论对异基因造血干细胞移植患者应高度关注CMV感染问题，坚持每周监测血CMV-DNA拷贝数，发现CMV血症及时给予抗病毒治疗，防止发生CMV病，是降低病死率的关键。Objective To evaluate the clinical value of cytomegalovirus （CMV） infection in patients with allogenic hemapoietic stem cell transplant （HSCT）. Methods CMV infection in HSCT recipients were monitored with the real-time fluorescent quantitative PCR method. Results In 115 patients with HSCT, there were 32 cases of patients with 1-3 times blood CMV positive, accounting for 27.83% （32/115）. 4 cases of patients were diagnosed as CMV disease, accounting for 12.5% and 25 cases accompanied a bacteria or fungi infection with for 78.13% （25/32）. 9 cases came to hematopoietic inhibition after HSCT. 15 cases from 83 cases of HSCT, who were CMV negative, came to hematopoietic inhibition after HSCT which have no significantly difference compared to that of patients who were CMV positive. Conclusion We should be paid attention to infection of CMV for patients with HSCT. The detection of CMV-DNA by real-time PCR is rapid and sensitive method to monitor CMV infection in patients after HSCT and guide antivirus therapy.

关 键 词：造血干细胞移植 聚合酶链反应 巨细胞病毒 

分 类 号：R457.7[医药卫生—治疗学]