血尿患儿尿和肾组织中巨细胞病毒抗原检测及其临床意义  

Detection and significance of cytomegalovirus antigen in urine and renal tissues by immunohistochemistry in children with hematuria

作　　者：栾江威[1] 吴燕祥[1] 熊嗣玉[1] 鲁建生[2] 李翠华[1] 王筱雯[1] 

机构地区：[1]武汉市儿童医院肾内科,430016 [2]武汉市儿童医院病理科,430016

出　　处：《中华儿科杂志》2001年第12期729-731,共3页Chinese Journal of Pediatrics

摘　　要：目的　探讨血尿患儿巨细胞病毒 (CMV)感染状况。方法　应用免疫组化链霉菌抗生物素蛋白 过氧化物酶连结法 ,检测 5 5例血抗CMV IgM阳性的血尿患儿尿中巨细胞病毒早期抗原(CMV EA) ,并对其中 6例行肾穿刺活检 ,进行肾组织中CMV EA检测。结果　单纯性血尿组患儿尿CMV EA阳性率为 80 %(32 / 40 )。非单纯性血尿组患儿尿CMV EA阳性率为 2 0 %(3/ 15 )。对照组尿CMV EA阳性率为 19%(10 / 5 3)。单纯性血尿组尿CMV EA阳性率明显高于非单纯性血尿组和对照组(P <0 0 0 5 ,P <0 0 5 )。 6例肾组织CMV EA检测 5例阳性 (83%)。肾组织CMV感染细胞多为皮质区小管上皮细胞。结论　巨细胞病毒感染可能是单纯性血尿的主要病因。Objective The infection with cytomegalovirus (CMV), which frequently occurs in our country, can lead to lesions of multiple organs. To clarify whether the kidney is the primary affected organ of the CMV infection, the CMV early antigen (CMV-EA) in urine and renal tissues of children with hematuria were detected, and the clinical significance of the detection was also remarked on. Methods By using the method of ELISA, blood samples from 180 children with glomrular-hematuria were screened for anti-CMV-IgM, 55 of them showed positive in blood. CMV-EA in urine samples from the 55 children was detected with immunohistochemistry (streptavidin-peroxidase or S-P method). Six of 55 infants received renal biopsies and CMV-EA in their renal tissues were also detected. Among the 55 children, 25 were male and 30 were female, the ages ranged from 2.5～14 years (with an average of 6.2 years). The 55 children were divided into two groups: asymptomatic hematuria group and symptomatic group. A control group of 53 children was set up at the same time. The positive rates of CMV-EA among these three groups were compared. Results (1)The positive rate of CMV-EA in children with asymptomatic hematuria was 80% (32/40), while the positive rates of CMV-EA in symptomatic group and control group were 20% (3/15) and 18.9% (10/53), respectively. The positive rate of CMV-EA in the group of asymptomatic hematuria was markedly higher than that in the group of symptomatic and control groups (χ 2=38.40, P<0.001). (2) Five of six children who received the renal biopsy were detected the CMV-EA in their renal tissues, the positive rate was 83% (5/6), 4 of 6 were from the group of asymptomatic hematuria. CMV-EA was observed frequently in renal tubular cells of the four children, whose pathological type was the mild mesangial proliferative glomerulonephritis (MsPGN). Two of 6 were from the nephritis group. CMV-EA, HBsAg and HBcAg were all positive in the renal tubular cells in one of them, whose pathological type was membranous glomerulopath

关 键 词：血尿 巨细胞病毒感染 免疫组织化学 抗原 儿童 

分 类 号：R446.6[医药卫生—诊断学]