PP65抗原血症检测法在发热患儿巨细胞病毒感染中的诊断价值

Diagnosis value of PP65 antigenemia assay in febrile children with cytomegalovirus infection

目的探讨低基质磷酸化蛋白（PP65）抗原血症检测法（AA法）对发热患儿巨细胞病毒（CMV）感染的诊断价值。方法对128例发热患儿（发热时间7～14d）采用间接免疫荧光染色法检测PP65抗原血症、酶联免疫吸附法（ELISA）检测抗CMV抗体（CMV—IgM）、尿光镜找包涵体等三种方法平行检测128例血标本和尿标本。结果PP65抗原血症、CMV—IgM、尿找巨细胞包涵体的阳性检出率分别为17．2％、8．6％、6．3％。PP65抗原血症与CMV—IgM及尿找巨细胞包涵体的阳性符合率分别为50％（11／22）、36％（8／22）。19例患儿随着病情好转，PP65抗原血症水平从阳性转为阴性，另3例临床痊愈时复查PP65仍为阳性，其中2例2周后复查PP65转为阴性，1例3周后复查转为阴性。结论PP65抗原血症检测法对CMV活动性感染具有早期诊断的意义，可以检测病情变化、指导早期干预治疗。

Objective To evaluate diagnosis value of PP65 antigenaemia assay （AA） on cytomegalovirus （CMV） infection in febrile children. Method One hundred and twenty- eight febrile children with febrile duration between one to two weeks, their blood preparations and urine aliquots were screened, indirect IF staining（ antigen PP65 ）, ELISA（CMV - IgM） and light microscope（ urinary cytomegalic inclusion）. Three methods above mentioned were used in all patients. Result The positive rate of PP65 antigenaemia,CMV- IgM and urinary cytomegalic inclusion was 17.2% ,8.6% ,6.3%, respectively. The positive coincidence rate of PP65 antigen with CMV - IgM and PP65 antigen with urinary cytomegalic inclusion was 50 % （ 11/22 ）, 36 % （8/22）, respectively. Nineteen childrens antigenaemia PP65 became negative with patient＇s condition improved. Three children＇s PP65 antigenaemia remained positive,when they were clinic cured. Two of them became negative after two weeks and one after three weeks. Conclusion Antigenaemia PP65 is effective in early diagnosis of active CMV infection, predicting patient＇s condition and providing early intervention and treatment.