不同样本中巨细胞病毒DNA载量在艾滋病合并巨细胞病毒肺炎早期诊断中的作用  

The early diagnostic value of Cytomegalovirus DNA load in different samples for cytomegalovirus pneumonia in AIDS patients

作　　者：邓佳 李宁沙 陈勇 DENG Jia;LI Ningsha;CHEN Yong(Department of Clinical Laboratory,the First Hospital of Changsha,Changsha,Hunan,410005,China)

机构地区：[1]长沙市第一医院检验科,湖南长沙410005

出　　处：《当代医学》2021年第23期58-60,共3页Contemporary Medicine

摘　　要：目的探讨不同样本中巨细胞病毒(CMV)DNA载量在艾滋病(AIDS)合并巨细胞病毒肺炎早期诊断中的作用。方法回顾性分析2010年1月至2017年6月在长沙市公共卫生救治中心艾滋病科住院首次诊治的AIDS合并CMV肺炎患者(AIDS合并CMV肺炎组,n=41)与单纯AIDS患者(单纯AIDS组,n=53)的临床资料,包含外周血单个核细胞(PBMC)及肺泡灌洗液(BALF)中CMV DNA载量。比较两组CMV DNA阳性率和载量,同时采用ROC曲线分析PBMC和BALF中CMV DNA载量对AIDS合并CMV肺炎的早期诊断价值。结果AIDS合并CMV肺炎组,PBMC中CMV DNA中位数水平为2.19×10^(3) Copies/mL,BALF中CMV DNA中位数水平为7.43×10^(4) Copies/mL,均高于单纯AIDS组,差异有统计学意义(Z=-5.047、-5.515,P<0.01);ROC曲线分析,PBMC中CMVDNA载量AUC为0.899,最佳临界值为4.27×10^(2) Copies/mL,敏感度为80.8%,特异度为88.5%;BALF中CMV DNA载量AUC为0.945,最佳临界值为1.62×10^(4) Copies/mL,敏感度为92.3%,特异度为81.2%;联合PBMC和BALF中CMV DNA载量分析,AUC为0.963,敏感度为96.2%,特异度为92.3%。结论联合检测PBMC和BALF中CMV DNA载量对AIDS合并巨细胞病毒肺炎早期诊断具有较高的敏感度和特异度,可为AIDS合并巨细胞病毒肺炎早期诊断提供检验依据。Objective To investigate the early diagnostic value of Cytomegalovirus(CMV)DNA load in different samples for CMV pneumonia in AIDS patients.Methods Clinical data of patients with AIDS combined with CMV pneumonia(AIDS combined with CMV pneumonia group,n=41)and patients with simple AIDS(simple AIDS group,n=53)hospitalized for the first time in the AIDS Department of Changsha Public Health Treatment Center from January 2010 to June 2017 were retrospectively analyzed.The clinical data included CMV DNA load of peripheral blood mononuclear cells(PBMC)and bronchoalveolar lavage fluid(BALF).The positive rate and load of CMV DNA were compared between the two groups.Receiver operating characteristic curves were analyzed to assess the early diagnostic value of CMV DNA load for CMV pneumonia in AIDS patients.Results The median levels of CMV DNA in PBMC and BALF were 2.19×10^(3)Copies/mL and 7.43×10^(4)Copies/mL in AIDS combined with CMV pneumonia group,respectively,both of which were higher than those in the simple AIDS group,the difference was statistically significant(Z=-5.047,-5.515,P<0.01).According to ROC curve analysis,the AUC of CMV DNA load in PBMC was 0.899,the most appropriate cut-off value was 4.27×10^(2)Copies/mL,(sensitivity was 80.8%and specificity was 88.5%),the AUC of CMV DNA load in BALF was 0.945,the most appropriate cut-off value was 1.62×10^(4)Copies/mL,(sensitivity was 92.3%and specificity was 81.2%),the AUC of combined testing(PBMC and BALF)was 0.963(sensitivity was 96.2%and specificity was 92.3%).Conclusion The combined detection of CMV DNA load in PBMC and BALF has high sensitivity and specificity for the early diagnosis of AIDS combined with cytomegalovirus pneumonia,which can provide a test basis for the early diagnosis of AIDS combined with cytomegalovirus pneumonia.

关 键 词：巨细胞病毒 艾滋病 支气管肺泡灌洗液 外周血单个核细胞 

分 类 号：R512.91[医药卫生—内科学] R563.1[医药卫生—临床医学]