血清与骨髓中细小病毒B19的检测及相关疾病探讨

Detection of parvovirus B19 infection in paired serum and bone marrow samples

目的 建立巢式PCR方法进行血清与骨髓标本中细小病毒B1 9(PVB1 9)的检测 ,并比较两者间的差异 ,进一步探讨某些疾病与PVB1 9感染的可能关系。方法 对住院治疗的 1 0 8例血液病患儿、1 33例正常儿童以及 2 3例成人血液病患者的血清标本应用巢式PCR进行PVB1 9DNA检测。 1 0 8例患儿中有 37例同时收集血清与骨髓涂片进行PCR扩增 ,另外有 37例同时应用ELISA方法进行PVB1 9特异性IgM检测。结果 ELISA实验中的 37例有 2例 ( 2 / 37,5 4 % )PVB1 9特异性IgM阳性。而巢式PCR检测阳性为 1 1例 ( 1 1 / 37,2 9 7% )。血液病患儿PVB1 9DNA总阳性率为2 7 8% ,其中ITP患儿中阳性率为 2 6 9% ,白血病患儿中阳性率 83 3% ;成人医院收集的血液标本中阳性率为 2 6 1 % ;正常儿童中未检测到PVB1 9DNA。同时收集了血清与骨髓涂片的 37例标本中血清PVB1 9DNA阳性率 2 7 0 % ( 1 0 / 37) ,骨髓涂片总检出率为 37 8% ( 1 4 / 37)。结论 巢式PCR方法与ELISA实验比较具有灵敏度高、特异性强的特点 ,而血清标本的敏感性要低于骨髓标本 ,在ITP、白血病等患者中PVB1

Objective To develop nested-PCR method for det ec tion of parvovirus B19 (PVB19) infection in paired serum and bone marrow samples , and to study the relationship which may exist among some disease and PVB19 inf ection. Methods PVB19 were detected by nested-PCR from serum specimens of 108 hospitalized children, 133 health children and 23 adult patient s in hematology ward. Otherwise, 37 out of 108 specimens were tested for parvov irus B19 by n ested-PCR from paired serum and bone marrow samples, as well as 37 out of 108 sp ecimens were by ELISA. Results Of the 108 serum samples, 30(2 7.8%) were found PVB19 positive by nested-PCR, including 14/52 in ITP patient, 5 /6 in leukaemia patient; 6(6/23,26.1%) in adult patients and none (0/133) of hea lth children were determined as PVB19 positive. In paired serum and bone marrow s amples, PVB19 positive ratio from serum versus bone marrow is 10/37 (27.0%):14/3 7 (37.8%). And 2 out of 37 specimens were PVB19 positive determined by ELISA. Conclusion Nested-PCR is more sensitive and specific method for detection of PVB19 from clinical specimens. It is less sensitive when serum sam ples are used rather than bone marrow. And there may exist relationship among PV B19 and ITP, leukaemia. <