尿毒症肾移植患者围手术期人巨细胞病毒基因检测及意义

Perioperative detection of human cytomegalovirus in renal transplant recipients with uremia and its clinical significance

目的探讨尿毒症患者肾移植围手术期人类巨细胞病毒(HCMV)基因检测的意义。方法肾移植患者外周血标本56例,健康对照组外周血标本15例。采用荧光定量PCR(FQ-PCR)技术测定标本中HCMV基因拷贝数,结合临床表现进行综合分析。结果56例患者术前HCMV异常表达21例(37.5%),男17例,女4例,检测值(3.84±2.72)×104基因拷贝数/ml;移植术后异常表达增至25例(44.6%),检测值(5.32±4.72)×104基因拷贝数/ml。对照组15例,异常表达1例(6.7%)。结论尿毒症患者肾移植围手术期HCMV基因拷贝数检测可以作为HCMV活动性感染的预警,为临床早期诊断、预防和治疗提供依据。

Objective To investigate the detection of human cytomegalovirus （HCMV） gene copy in peripheral blood of patients with uremia before and after renal transplantation and its clinical significance, Methods The peripheral blood samples of 56 renal transplant recipients with uremia and 15 healthy con-trols were taken for detection of HCMV gene copy by fluorescence quantitative PCR （FQ-PCR） technique, The result and its significance were analyzed. Results Of the 56 samples of pre-renal transplantation cases,21 cases （17 men and 4 women） had positive HCMV-DNA copy result, with the positive rate being 37.5%, The detective value of HCMV-DNA copies in positive samples was （ 3.84±2.72 ）×10^4/ml, After renal transplantation, the number of cases with positive results rose to 25 in the transplantation group, with the positive rate being 44.6% , and the value of HCMV-DNA copies was （5.32 ±4.72）×10^4/ml. The difference between the pair-matching data before and after renal transplantation was significant （ t = 2.008, P = 1.711 ）. There was only 1 case with positive results in 15 healthy controls, with the positive rate being 6.67%. Conclusions It is suggested that HCMV gene copy may be a predictor of active HCMV infection and that monitoring of HCMV gene copy in peripheral blood of patients with uremia before and after renal transplantation is of great help for early diagnosis, prevention and treatment of the disease.