CMV-IgM、CMV-DNA联合LDH对婴幼儿巨细胞病毒肺炎的诊断价值  

Diagnostic value of CMV-IgM and CMV-DNA combined LDH in infantile cytomegalovirus pneumonia

作　　者：梁红峰 许秋桂 范慧婕 姚锦绣 林裕锋 黎杨杨 LIANG Hong-feng;XU Qiu-gui;FAN Hui-jie(Department of Laboratory Medicine,Yangjiang People's Hospital,Yangjiang Guangdong 529500,China)

机构地区：[1]阳江市人民医院检验科,广东阳江529500

出　　处：《临床和实验医学杂志》2021年第12期1321-1323,共3页Journal of Clinical and Experimental Medicine

基　　金：2018年度阳江市医疗卫生类科技计划项目(社发[2018]24);2019年阳江市协同创新专项资金项目(编号:2019010);2016年广东省自然科学基金(编号:2016A00153)。

摘　　要：目的探讨巨细胞病毒抗体M(CMV-IgM)、CMV-DNA联合乳酸脱氢酶(LDH)检测在婴幼儿巨细胞病毒(CMV)肺炎诊断中的价值。方法回顾性选取2019年6月至2020年10月在阳江市人民医院就诊接受治疗的已确诊为CMV肺炎患儿97例(病例组)、健康体检婴幼儿103例(对照组)为研究对象。记录2组血清CMV-IgM、CMV-DNA阳性率及生化指标水平并进行比较,结合受试者工作特征(ROC)曲线评价CMV-IgM、CMV-DNA联合LDH在CMV肺炎患儿中的诊断价值。结果病例组中血清CMV-IgM、CMV-DNA阳性率为85.0%、77.3%,高于对照组的14.6%和2.0%,差异均有统计学意义(P<0.05)。病例组中丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、LDH及C反应蛋白(CRP)水平分别为(67.99±8.64)U/L、(52.17±5.82)U/L、(424.78±19.27)U/L和(19.84±2.19)mg/L,明显高于对照组[(33.86±6.18)U/L、(27.67±7.46)U/L、(201.47±38.15)U/L和(8.60±0.88)mg/L],差异均有统计学意义(P<0.05)。经ROC曲线分析CMV-IgM、CMV-DNA联合LDH检测的曲线下面积、灵敏度、特异度和准确度分别为0.978、95.9%、92.2%和100.0%,均高于各单一指标及CMV-IgM、CMV-DNA联合检测。结论CMV-IgM、CMV-DNA联合LDH检测在CMV肺炎患儿的诊断中具有较高的临床应用价值。Objective To explore the diagnostic value of combined detection of cytomegalovirus(CMV)-IgM,CMV-DNA and lactate dehydrogenase(LDH)in infantile cytomegalovirus pneumonia.Methods A total of 97 infants with cytomegalovirus pneumonia(case group)treated in the Yangjiang People′s Hospital from June 2019 to October 2020 and 103 healthy infants(control group)at the same time were selected as the research subjects.CMV-IgM,CMV-DNA and biochemical indexes were detected in both groups.The differences in the positive rates of CMV-IgM and CMV-DNA and biochemical indexes were analyzed in each group.The diagnostic value of single CMV-IgM,CMV-DNA and combined LDH in infantile cytomegalovirus pneumonia were compared by receiver operating characteristic curve(ROC)curve.Results The positive rates of serum CMV-IgM and CMV-DNA in the case group were 85.0%and 77.3%,which were higher than those in the control group(14.6%and 2.0%),and the differences were statistically significant(P<0.05).The levels of alanine transaminase(ALT),aspartic transaminase(AST),LDH and C reactive protein(CRP)in case group were(67.99±8.64)U/L,(52.17±5.82)U/L,(424.78±19.27)U/L and(19.84±2.19)mg/L,which were significantly higher than those in control group[(33.86±6.18)U/L,(27.67±7.46)U/L,(201.47±38.15)U/L and(8.60±0.88)mg/L],and the differences were statistically significant(P<0.05).Through the ROC curve analysis,the area under the curve,sensitivity,specificity and accuracy of CMV-IgM,CMV-DNA and LDH in combined diagnosis of CMV pneumonia were 0.978,95.9%,92.2%and 100.0%,and had better diagnostic value than the single indicator and CMV-IgM combination with CMV-DNA.Conclusion Combined with CMV-IgM,CMV-DNA and LDH detection in infant of CMV pneumonia has a better diagnostic value.

关 键 词：巨细胞病毒肺炎 婴幼儿 CMV-IgM CMV-DNA 乳酸脱氢酶 

分 类 号：R725.6[医药卫生—儿科]