器官移植术后外周血巨细胞病毒及其抗原和DNA的检测

Detection of cytomegalovirus antigens and virus DNA in the peripheral blood after organ transplantation

目的 探讨及时诊断器官移植受者术后活动性巨细胞病毒（ 简称ＣＭＶ） 感染。方法 采集３２ 例器官移植受者术后８９ 份血标本，同时用酶免疫组织化学作抗原血症和病毒分离培养作病毒血症的检测。再以原位杂交（ＩＳＨ） 和聚合酶链反应（ＰＣＲ） 作ＤＮＡ 血症的检测。结果 ８９ 份血标本中，抗原血症阳性３５ 份（３９－３％ ），病毒血症阳性２５ 份（２８－１ ％） ，ＤＮＡ 血症的位杂交检测阳性３７ 份（４１－６ ％） 及ＤＮＡ血症ＰＣＲ 检测阳性５１ 份（５７－３％ ）。结论 ＤＮＡ血症原位杂交和ＰＣＲ 技术及抗原血症的检测方法，具有检测率高且时间早的优点，能作为临床快速检测ＣＭＶ的方法。本结果与移植受者的临床症状相关。

Objective To diagnose timely the cytomegalovirus(CMV) infection of recipients after organ transplantation.Methods Thirty two organ transplanted recipients were demonstrated for CMV infection based on detection of antigenemia by immunoperoxidase assay, viremia with virus isolation, DNAemia by polymerase chain reaction (PCR) and in situ hybridization (ISH) in peripheral blood samples. Results Of 89 blood specimens examined, 35(39.3%) were positive for antigenemia, 25(28.1%) for viremia, 37(41.6%) for DNAemia by ISH, and 51(57.3%) for DNAemia by PCR. The results indicated that DNAemia assay with ISH and PCR and antigenemia assay were suitable methods for rapid, early, and sensitive detection of CMV infection. The results correlated with clinical symptoms. Conclusion We suggest that detection of antigenemia, viremia, and DNAemia can monitor CMV infection of organ transplaned recipients and provide indication to antiviral therapy.