CMV-IgM、CMV-DNA及外周血T淋巴细胞在巨细胞病毒肝炎患儿中的变化及其意义  

Changes of CMV-IgM,CMV-DNA and Peripheral Blood T Lymphocytes in Children with Cytomegalovirus Hepatitis and Its Significance

作　　者：林裕锋 许秋桂 姚锦绣 LIN Yufeng;XU Qiugui;YAO Jinxiu(Yangjiang People's Hospital,Yangjiang 529500,China;不详)

机构地区：[1]阳江市人民医院,广东阳江529500

出　　处：《中外医学研究》2023年第1期79-83,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：阳江市医疗卫生类科技计划项目(社发[2018]24)。

摘　　要：目的:探讨巨细胞病毒(CMV)肝炎患儿血清CMV-IgM、CMV-DNA及外周血T淋巴细胞的变化及其意义。方法:选取阳江市人民医院2018年8月-2021年8月确诊的98例CMV肝炎患儿(CMV组)及同期在本院儿保科进行常规保健的100例健康婴幼儿(对照组)。对比两组的CMV-IgM、CMV-DNA、外周血T淋巴细胞水平,分析T淋巴细胞与患儿肝功能损伤程度的关系。结果:CMV组的血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)测定值高于对照组,血清白蛋白(ALB)测定值低于对照组,差异均有统计学意义(P<0.05)。CMV组的外周血CD3^(+)CD8^(+)T细胞测定值高于对照组,CD3^(+)CD4^(+)T细胞、CD4^(+)/CD8^(+)测定值低于对照组,差异均有统计学意义(P<0.05)。CMV组的血清CMV-IgM阳性率为87.76%、CMV-DNA阳性率为64.29%,均高于对照组,差异均有统计学意义(P<0.05)。CMV肝炎患儿的CD3^(+)CD4^(+)T细胞与ALT、AST、总胆红素(TBIL)均呈负相关性,CD3^(+)CD8^(+)T细胞与ALT、AST、TBIL均呈正相关性,CD4^(+)/CD8^(+)与ALT、AST、TBIL均呈负相关性(P<0.05)。CMV-Ig M诊断CMV肝炎患儿的敏感度为87.76%、特异度为86.00%;CMV-DNA诊断CMV肝炎患儿的敏感度为64.29%、特异度为100%。结论:CMV肝炎患儿血清呈现明显的免疫功能失衡,并且与肝功能受损程度有关,CMV-IgM诊断CMV肝炎敏感度较高,CMV-DNA诊断CMV肝炎患儿特异度较高,临床上可考虑将二者联合检测,提高诊断效率。Objective:To investigate the changes of serum cytomegalovirus(CMV)-IgM,CMV-DNA and peripheral blood T lymphocytes in children with CMV hepatitis and its significance.Method:A total of 98 children with CMV hepatitis(CMV group)diagnosed in Yangjiang People’s Hospital from August 2018 to August 2021 and 100 healthy infants(control group)who received routine health care in the Child Care Department of our hospital in the same period were selected.The levels of CMV-IgM,CMV-DNA and peripheral blood T lymphocytes in the two groups were compared,and the relationship between T lymphocytes and the degree of liver function injury was analyzed.Result:The serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in CMV group were higher than those in the control group,and the serum albumin(ALB)was lower than that in the control group,the differences were statistically significant(P<0.05).The measured values of peripheral blood CD3^(+)CD8^(+)T cells in the CMV group was higher than that in the control group,while the measured values of CD3^(+)CD4^(+)T cells and CD4^(+)/CD8^(+)were lower than those in the control group,the differences were statistically significant(P<0.05).The positive rates of serum CMV-IgM and CMV-DNA in CMV group were 87.76%and 64.29%respectively,which were higher than those in control group(P<0.05).CD3^(+)CD4^(+)T cells in children with CMV hepatitis were negatively correlated with ALT,AST and total bilirubin(TBIL),CD3^(+)CD8^(+)T cells were positively correlated with ALT,AST and TBIL,and CD4^(+)/CD8^(+)were negatively correlated with ALT,AST and TBIL(P<0.05).The sensitivity and specificity of CMV-IgM in the diagnosis of CMV hepatitis in children were 87.76%and 86.00%respectively.The sensitivity and specificity of CMV-DNA in the diagnosis of CMV hepatitis in children were 64.29%and 100%respectively.Conclusion:The serum of children with CMV hepatitis shows obvious imbalance of immune function,which is related to the degree of liver function damage.The sensitivity of CMV-IgM in the diagnosis of

关 键 词：巨细胞病毒 感染 巨细胞病毒IgM 巨细胞病毒DNA T淋巴细胞 肝损伤 

分 类 号：R725.1[医药卫生—儿科]