慢性结膜炎患者泪液中腺病毒与单纯疱疹病毒的检测

Detection of adenovirus and herpes simplex virus in the tears of chronic conjunctivitis

目的探讨慢性结膜炎患者泪液标本中腺病毒和单纯疱疹病毒的表达情况。方法实验研究。2008年11月至2009年6月期间，在北京大学第三医院、北京大学眼科中心门诊采集81例临床确诊为慢性结膜炎（成人组66例、儿童组15例）、9例急性病毒性结膜炎及30例健康者的双眼泪液标本，采用聚合酶链反应（PCR）法特异性检测腺病毒及单纯疱疹病毒核酸的存在情况，并对PCR阳性结果结合临床症状和体征进行分析。采用两个样本例数的卡方检验。结果在慢性结膜炎患者中，腺病毒阳性率为32．1％（26／81），单纯疱疹病毒阳性率为30．9％（25／81）。在慢性结膜炎的儿童组患者中腺病毒阳性率为33．3％（5／15），单纯疱疹病毒阳性率为13．3％（2／15）。成人组中腺病毒的阳性率为31．8％（21／66），单纯疱疹病毒阳性率为34．8％（23／66）。在既往有急性结膜炎病史的患者中腺病毒的阳性率为61．5％（16／26），与既往无急性结膜炎病史的患者比较，差异有统计学意义（x^2=16．884，P〈0．01）。单纯疱疹病毒阳性率为42．3％（11／26），与既往无急性结膜炎病史的患者比较，差异有统计学意义（x^2=5．351，P=0．021）。正常阴性对照组病毒检测阳性率均为0％（0／30），阳性对照组即急性病毒性结膜炎组腺病毒阳性率为100．0％（9／9）。81例慢性结膜炎患者中腺病毒和（或）单纯疱疹病毒阳性者为37例。病毒检测阳性的患者中64．9％（24／37）的患者出现眼红症状，56．8％（21／37）的患者出现眼痒症状，32．4％（12／37）的患者兼有眼红和眼痒，73．0％（27／37）的患者临床体征表现有下睑滤泡。结论慢性结膜炎患者中腺病毒和单纯疱疹病毒的表达占有相当的比例，既往有明确感染史的患者病毒阳性率明显高于无既往感染史患者。

Objective To analyze the tears of outpatients who had chronic conjunctivitis infected adenovirus （AdV） and （or） herpes simplex virus （HSV）. Methods It was an experimental study. 81 patients with chronic conjunctivitis （adult 66 cases, children 15 cases ）, 9 cases with acute viral conjunctivitis and 30 healthy control cases. To collect their tears, use polymerase chain reaction （PCR） to detect herpes simplex virus and adenovirus, and analyze the results of PCR, clinical symptoms and signs. Results In patients with chronic conjunctivitis, adenovirus-positive rate was 32. 1% （26/81） and herpes simplex virus-positive rate was 30. 9% （25/81）. In children patients with chronic conjunctivitis, the adenovirus-positive rate was 33.3 % （5/15） and herpes simplex virus-positive rate was 13.3 % （2/15）. In adult group, the adenovirus-positive rate was 31.8% （21/66） and herpes simplex virus-positive rate was 34. 8% （23/66）. In patients who underwent acute conjunctivitis, the adenovirus-positive rate was 61.5% （16/26）. It has statistical differences （x^2 = 16. 884,P 〈0.01 ） with no acute conjunctivitis patients. The herpes simplex virus-positive rate was 42. 3% （ 11/26）. It has statistical differences （ x^2 = 5. 351, P = 0. 021 ） with no acute conjunctivitis patients. The positive rate of virus detection was 0% （0/30） in the normal negative control group. The adenovirus-positive rate was 100. 0% （9/9） in the positive control grouppatients with acute viral conjunctivitis. 37 patients were adenovirus-positive and （or） herpes simplex viruspositive. The rate of redness with itching was 32.4% （12/37） in virus positive patient. The rate of redness was 64. 9% （24/37）. The rate of itching was 56. 8% （21/37）. The rate of lower eyelid follicles was 73.0% （27/37） in virus positive patients. Conclusions The rate of adenovirus and herpes simplex virus positive expression is considerable in the patients with chronic conjunctivitis. The positive rate of patients with the history of virus infection is rather higher than no infection history.