巨细胞病毒核酸与抗体检测在婴幼儿巨细胞病毒感染诊断中的应用价值  

Application Value of Cytomegalovirus Nucleic Acid and Antibody Detection in Diagnosis of Cytomegalovirus Infection in Infants and Children

作　　者：罗诗蓝 付汉东 Luo Shilan;Fu Handong(Jinzhou Medical University,Jinzhou 121000,Liaoning Province,China;Postgraduate Training Base of Jinzhou Medical University,The Central Hospital of Xiaogan,Xiaogan 432000,Hubei Province,China)

机构地区：[1]锦州医科大学,辽宁锦州121000 [2]锦州医科大学研究生培养基地,孝感市中心医院,湖北孝感432000

出　　处：《中国社区医师》2023年第19期84-86,89,共4页Chinese Community Doctors

基　　金：2022孝感市自然科学计划项目(编号:XGKJ2022010019);湖北省卫生健康委联合基金项目(编号:WJ2019H247)。

摘　　要：目的:分析人巨细胞病毒核酸(HCMV-DNA)与人巨细胞病毒抗体(HCMV IgM/IgG)检测在婴幼儿巨细胞病毒(HCMV)感染诊断中的应用价值。方法:选取2019年5月—2020年5月孝感市中心医院收治的988例疑似HCMV感染患儿作为研究对象,同时检测HCMV IgG/IgM与HCMV-DNA,分析其在HCMV感染诊断中的应用价值。结果:婴儿组HCMV-DNA阳性率最高,幼儿组次之,新生儿组最低,三组阳性率比较,差异有统计学意义(P<0.05)。HCMV-IgM抗体与HCMV-DNA检测方法一致性差(Kappa=0.08);两种检测方法阳性率比较,差异有统计学意义(P<0.05)。239例HCMV-DNA阳性患儿中,高胆红素血症48例(20.1%),肝功能异常46例(19.2%),占比较高;20例IgM阳性患儿中,肝功能异常6例(30.0%),婴儿肝炎综合征3例(15.0%),占比较高。母乳HCMV阳性检出55例(32.4%),尿液HCMV阳性检出20例(11.8%),高于尿液标本,差异有统计学意义(P<0.05)。结论:临床针对疑似HCMV感染的患儿,可多次检测不同日龄不同标本的HCMV-DNA和(或)HCMV IgM/IgG来确定是否感染HCMV。Objective:To analyze the application value of human cytomegalovirus nucleic acid(HCMV-DNA)and human cytomegalovirus antibody(HCMV IgM/IgG)detection in the diagnosis of human cytomegalovirus(HCMV)infection in infants and children.Methods:A total of 988 children with suspected HCMV infection admitted to the Central Hospital of Xiaogan from May 2019 to May 2020 were selected as the study subjects.HCMV IgG/IgM and HCMV-DNA were detected simultaneously,and the application value in HCMV infection diagnosis was analyzed.Results:The positive rate of HCMV-DNA was the highest in the infant group,followed by the children group,and the lowest in the neonatal group,and the positive rate of the three groups showed significant difference(P<0.05).The consistency between HCMV-IgM antibody and HCMV-DNA detection was poor(Kappa=0.08).The positive rates of the two detection methods showed significant difference(P<0.05).Among the 239 HCMV-DNA-positive children,48 cases(20.1%)had hyperbilirubinemia and 46 cases(19.2%)had abnormal liver function,accounting for a relatively high proportion.Among the 20 IgM-positive children,6 cases(30.0%)had abnormal liver function and 3 cases(15.0%)had infantile hepatitis syndrome,accounting for a relatively high proportion.HCMV positive in breast milk was detected in 55 cases(32.4%),and HCMV positive in urine was detected in 20 cases(11.8%).The detection rate of breast milk was higher than that of urine samples,and the difference was statistically significant(P<0.05).Conclusion:For suspected HCMV infection in children,HCMV-DNA and/or HCMV IgM/IgG of different specimens at different days of age can be detected for several times to determine whether HCMV infection is possible.

关 键 词：巨细胞病毒感染 巨细胞病毒IgM 巨细胞病毒DNA 

分 类 号：R725.1[医药卫生—儿科]