联合检测CMV-IgM及CMV-DNA对婴幼儿巨细胞病毒肝炎的诊断价值  

The diagnostic value of combined detection of CMV-IgM and CMV-DNA in infantile cytomegalovirus hepatitis

作　　者：谢付静[1] 陈大力[2] 杨亚培[3] 刘洪波 XIE Fujing;CHEN Dali;YANG Yapei;LIU Hongbo(Department of Pediatrics,Liaocheng People′s Hospital,Liaocheng,Shandong 252000,China;Department of Clinical Laboratory,Weifang Yidu Central Hospital,Weifang,Shandong 262500,China;Central Laboratory,Liaocheng People′s Hospital,Liaocheng,Shandong 252000,China)

机构地区：[1]山东省聊城市人民医院儿科,252000 [2]山东省潍坊市益都中心医院检验科,262500 [3]山东省聊城市人民医院中心实验室,252000

出　　处：《重庆医学》2018年第11期1485-1487,共3页Chongqing medicine

基　　金：中国博士后科学基金面上项目(2013M531617)

摘　　要：目的探讨联合检测巨细胞病毒(CMV)-IgM及CMV-DNA对婴幼儿巨细胞病毒肝炎的诊断意义。方法采用化学发光法检测聊城市人民医院122例确诊巨细胞病毒肝炎患儿(病例组)的血清CMV-IgM,同时用荧光探针PCR法检测患儿血清与尿液的CMV-DNA;另选择该院同期186例无感染症状健康儿童为对照组。分析各组肝炎患儿CMV-IgM和CMV-DNA的阳性率差异,并通过受试者工作特征(ROC)曲线比较单独及联合检测CMV-IgM、CMV-DNA在诊断婴幼儿巨细胞病毒肝炎中的价值。结果病例组CMV-IgM和CMV-DNA的阳性率均高于对照组,差异有统计学意义(P<0.05)。根据年龄分组,1d至6个月组CMV-IgM及CMV-DNA联合检测的总阳性率最高;在以临床特征分组中,黄疸组CMV-IgM及CMV-DNA联合检测的总阳性率最高,以上差异均有统计学意义(P<0.05)。经ROC曲线分析病例组CMV-IgM及CMV-DNA联合检测的曲线下面积最大,灵敏度、特异度、阳性预测值、阴性预测值均最大,诊断价值最高。结论联合检测CMV-IgM、CMV-DNA比单独检测对婴幼儿巨细胞病毒肝炎有更好的诊断价值。Objective To explore the diagnostic value of combined detection of CMV-IgM and CMV-DNA in infantile cytomegalovirus hepatitis.Methods The serum CMV virus antibodies of 122 children diagnosed of cytomegalovirus hepatitis in Liaocheng People′s Hospital was detected by chemiluminescence,while using fluorescent Probe PCR assay with serum and urine CMV-DNA,The other patients from the health examination center with no infection in children were subject to control group.The differences of CMV antibody and CMV-DNA positive rate were analyzed in infant of cytomegalovirus hepatitis.The diagnostic value of single and combined CMV-IgM and CMV-DNA in infant cytomegalovirus hepatitis was compared by ROC curve.Results Compared with the control group,There were significant differences in the positive rates of CMV-IgM and CMV-DNA(P<0.01).According to the age group,the total positive rate of 1 days to 6 months group combined with CMV-IgM and CMV-DNA in the highest;clinical features of grouping,the total positive rate of CMV-IgM and CMV-DNA the highest jaundice group,the differences were statistically significant(P<0.05).Through the ROC curve analysis,the curve of the joint detection of CMV-IgM and CMV-DNA in the hepatitis group was the largest,and the sensitivity,specificity,positive predictive value and negative predictive value were the highest,and the diagnostic value was the highest.Conclusion Combined with CMV-IgM and CMV-DNA detection in infant of cytomegalovirus hepatitis has a better diagnostic value.

关 键 词：肝炎 病毒性 人 巨细胞病毒 IGM DNA 

分 类 号：R725.7[医药卫生—儿科]