半套式荧光定量聚合酶链反应检测肾移植前后人巨细胞病毒感染状态

Detecting Status of Human Cytomegalovirus Infection by Quantitative AmpliSensor PCR in Preoperative and Postoperative Renal Allograft Recipients

目的：研究肾移植受者手术前后人巨细胞病毒（ＨＣＭＶ）的感染率及ＨＣＭＶＤＮＡ含量变化。方法：采用半套式荧光定量聚合酶链反应（ＡｍｐｌｉＳｅｎｓｏｒＰＣＲ）方法定量检测术前肾移植受者６１例，术后３２例，用四格表比较手术前、后的感染率，用ｔ检验比较病毒含量。结果：手术前、后肾移植受者ＨＣＭＶ的感染率分别为７７％和８７５％；ＨＣＭＶＤＮＡ平均含量（拷贝数每升）分别是１０７×１０７Ｌ－１和７４１×１０７Ｌ－１，两者之间感染率无显著差异（χ２＝１６５Ｐ＞００５），但病毒平均含量存在极显著差异（ｔ＝６４６Ｐ＜００１）。结论：研究结果显示：①免疫抑制治疗激活了潜伏性ＨＣＭＶ感染，导致术后ＨＣＭＶ含量显著增加；②决定肾移植受者ＨＣＭＶ感染状态的主要是机体本身的免疫力，减少ＨＣＭＶ感染，术后合理使用免疫抑制剂。

Objective: To determine the incidence of human cytomegalovirus(HCMV) infection and the quantity of the virus in the peripheral blood in preoperative and postoperative renal allograft recipients. Method: 61 preoperative and 32 postoperative renal allograft recipients were detected by quantitative AmpliSensor PCR. The incidence of HCMV infection and the quantity of HCMV in peripheral blood were subsequently analysed by χ 2 test and t test,respectively. Results: The incidence of HCMV infection in preoperative and postoperative renal allograft recipients were 77% and 87 5%,respectively. Their quantities of HCMV in peripheral blood were 1.07×10 7 L -1 and 7.41×10 7 L -1 , respectively. The difference in incidence of HCMV infection was not significant ( χ 2 =1.65, P >0 05), and the difference in HCMV quantity was highly significant ( t =6.46, P <0 01). Conclusions: Results indicate that ①immunosuppressive therapy reactivates latent HCMV infection; ②status of HCMV infection is chiefly determined by recipient′s own immunity. In order to decrease the incidence of HCMV infection, it is more important to make use of immunosuppressant reasonably and avoid overimmunosuppression.