痰和肺泡灌洗液CMV-DNA检测的临床意义探讨  

The study on the detection of Sputum and BALF of cytomegalovirus DNA

作　　者：杜云[1] 陈强[1] 章高平[1] 胡玉[1] 朱晓华[1] 吴爱民[1] 

机构地区：[1]江西省儿童医院呼吸科,南昌330006

出　　处：《江西医药》2015年第12期1375-1378,共4页Jiangxi Medical Journal

摘　　要：目的寻找早期诊断巨细胞病毒肺炎的指标。方法选取实验50例小儿肺炎病例,所有患儿血CMV-Ig M均为阳性,分为婴儿组及幼儿组,收集痰液及肺泡灌洗液,采用荧光实时定量PCR技术检测CMV-DNA,分析对比痰液及肺泡灌洗液巨细胞病毒检出情况;对照组为12例血CMV-Ig M为阳性的非肺炎病例,完善肺泡灌洗液CMV-DNA检测,比较实验组和对照组的肺泡灌洗液CMV-DNA检测结果。结果⑴对比实验组和对照组的肺泡灌洗液CMV-DNA检测结果,两组比较,差异有统计学意义（χ^2=12.402,P〈0.001）。⑵实验组中,对比痰及肺泡灌洗液CMV-DNA检测结果,两组比较,差异无统计学意义（χ^2=1.000,P=0.317）。同时对比痰及肺泡灌洗液高载量组（CMV-DNA〉1×105copies/ml）,两组比较,差异有显著统计学意义（χ^2=19.385,P〈0.001）。⑶婴儿组与幼儿组痰CMV-DNA高载量组阳性率进行对比,两组比较,差异有统计学意义（χ^2=5.965,P〈0.05）;婴儿组与幼儿组肺泡灌洗液CMV-DNA高载量组阳性率进行对比,两组比较,差异有统计学意义（χ^2=3.861,P〈0.05）。结论肺泡灌洗液CMV-DNA检测结果较痰CMV-DNA检测结果更有意义,不同年龄段巨细胞病毒肺炎的检出率不同。Objective To explore the diagnosis of cyiomegalovirus pneumonia,the detection of CMV DNA in bronchoalveolar lavage fluid is more heipful than that in sputum. Children＇s age is one of the factors that might influence the diagnosis of cytomegalovirus pneumon. Acurrate diagnosis of cytomegalovirus pneumon can help to reduce the adverse reaction of ganciclovir. Methods Experimental group ： choose fifty pneumonia children whose detection of CMV-IgM in blood is positive, divide them into the infant group and the preschool children group. CMV DNA in sputum and bronchoalyeolar lavage fluid was detected by real time PCR. comparing the results of sputum and bronchoalveolar lavage fluid CMV-DNA. Control group： detect CMV DNA in the bronchoalveolar lavage fluid of twelve children without pneumonia whose detection of CMV-IgM in blood is positive. Comparing the results of two groups. Results 1.Comparing the results of experimental group and control group, there was significant difference between them. 2.in all patients with positive detection of CMV-IgM in blood,the detection of CMV-DNA in sputum and BALF was seperately compared,we found that there was no significant difference between sputum CMV-DNA positive rate （84%） and BALF CMV-DNA positive rate （76%）. But we found that there was significant difference between the high titre of sputum CMV- DNA positive rate（53%） and the high titre of BALF CMV-DNA positive rate（14%）. 3.there was significant difference between the high titre of BALF CMV-DNA positive rate in the infant group and the high titre of sputum and BALF CMV-DNA positive rate in the preschool children group. Conclusion BALF CMV-DNA is more meaningful than sputum CMV-DNA. Among infants,Theincidence of cytomegalovirus pneumonia is varied according to different ages. In the diagnosis of cytomegalovirus pneumonia, we must take some factors into consideration,including patient＇s age, clinical manifestation,therapeutic effect, cytomegalovirus virological evidence ,the effect of antibiotics in the tr

关 键 词：巨细胞病毒肺炎 血CMV-IgM 痰CMV-DNA检测 支气管肺泡灌洗液CMV-DNA检测 

分 类 号：R725.6[医药卫生—儿科]