用PCR检测乙型肝炎患者血清巨细胞病毒活动性感染

Detection of active cytomegalovirus infection in serum from patients with hepatitis B using polymerase chain reaction (PCR)

应用聚合酶链反应（ＰＣＲ）技术检测１２５例乙型肝炎患者血清中巨细胞病毒脱氧核糖核酸（ＣＭＶ－ＤＮＡ）诊断ＣＭＶ活动性感染。同时与酶联免疫吸附法（ＥＬＩＳＡ）检测血清中ＣＭＶ－ＩｇＭ的结果相比较。结果显示：ＣＭＶ－ＤＮＡ阳性率为３２．８０％，明显高于ＣＭＶ－ＩｇＭ阳性率１５．２０％。各型肝炎中，急性肝炎、慢性肝炎、肝硬化血清ＣＭＶ－ＤＮＡ阳性率分别为１９．０５％，３５．６３％，３５．２９％。与血清ＣＭＶ－ＤＮＡ阴性的乙肝患者比较，血清ＣＭＶ－ＤＮＡ阳性的乙肝患者ＴＢ、ＡＬＴ水平及肝功能复常天数均明显升高或延长，并伴有发热、呕吐、黄疸、肝大症状体征的加重。提示：ＰＣＲ技术敏感性明显高于ＥＬＩＳＡ法，对乙肝患者ＣＭＶ活动性感染能比较准确地早期作出诊断。乙肝患者易合并ＣＭＶ活动性感染，ＣＭＶ与ＨＢＶ双重感染使患者病情加重，病程延长。

Cytomegalovirus (CMV) DNA in serum samples from 125 patients with hepatitis B was detected by polymerase chain reaction (PCR) Active CMV infection was defined as CMV DNA was positive As a comparison, CMV IgM was monitored at the same time by using enzyme linked immunosorbent assay (ELISA) The results showed that the positive rate of CMV DNA (32 80%) was singnificantly higher than that of CMV IgM (15 20%) Of the 125 patients, the rate of CMV DNA was 19 05% for acute hepatitis, 35 63% for chronic hepatitis, 35 29% for liver cirrhosis Compared with that of controls, the level of total serum bilirubin (TB), and serum alanine aminotransferase (ALT) in the CMV DNA positive patients with hepatitis B were singnificantly higher Their convalescences of liver function become longer, accompanying with the aggravation of fever, vomit, jaundice, and hepatomegaly Those results suggest that the sensitivity of PCR is higher than that of ELISA, and the early diagnosis of active CMV infection of patients with hepatitis B can be achieved by the detection of CMV DNA in serum using PCR These patients are vulnerable to active CMV infection The superinfection of HBV and CMV may intensify the disease and prolong its course