人巨细胞病毒被膜磷蛋白pp65的检测及其在肾移植受者CMV病诊断中的临床应用

Clinical value of human cytomegalovirus phosphoprotein 65 in the diagnosis of cytomegalovirus disease

目的建立一种简便诊断肾移植受者人巨细胞病毒(HCMV)活动性感染的方法。方法运用催化信号扩增法检测外周血白细胞中的人巨细胞病毒被膜磷蛋白pp65,并与抗HCMV-IgM检测法作比较。结果检测100例肾移植受者中,HCMVpp65抗原阳性47例,IgM抗体检测阳性41例,pp65抗原阳性细胞数为(71±45)个/2×105个WBC,而有症状的CMV病29例,抗原阳性细胞指数为(83±46)个/2×105个WBC。对照组50名健康人,pp65抗原检测全为阴性。pp65的敏感性、特异性、阳性预测值与阴性预测值分别是100%、74.6%、61.7%和100%。结论该法敏感、简便,可作为肾移植术后HCMV病的早期诊断并可指导抗病毒治疗。

Objective To establish a convenient method for diagnosis of active human cytomegalovirus （HCMV） infection in renal transplant recipients. Methods The expression ofHMCV phosphoprotein 65 （HCMV pp65） antigen in the peripheral blood leucocytes was detected by catalyzed signal amplification （CSA）, and the results were compared with those by detection of the serum HCMV pp65 using anti-HCMV-IgM. Results Of the 100 renal transplant recipients, 47 were positive for HCMV pp65 in the peripheral blood leucocytes, with the antigen-positive cell number of （71±45）/2×10^5 WBC, and 41 recipients were positive for anti-HCMV-IgM. In the 29 recipients presenting symptoms of HCMV infection, the antigen-positive cell number averaged （83±46）/2×10^5 WBC. All the 50 healthy control subjects showed negative results of pp65 and anti-HCMV-IgM. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of this leukocyte-based HCMV pp65 detection were 100%, 74.6%, 61.7% and 100%, respectively. Conclusion This method provides a sensitive and convenient approach for diagnosis of HCMV infection, which may also provide evidence for adequate administration of the antivirai treatment.