两种聚合酶链反应在单纯疱疹脑炎诊断中的应用

The Comparative Research of Two Different PCR in the Early and Rapid Diagnosis of Herpes Simplex Virus Encephalitis

目的比较并探讨两种聚合酶链反应技术在单纯疱疹病毒性脑炎（HSE）早期快速诊断中的应用价值。方法选择30例临床确诊的病毒性脑炎患者，分别运用由两种不同引物组成的聚合酶链反应（PCR）和巢式聚合酶链反应（nested－PCR）测定脑脊液中的单纯疱疹Ⅰ型病毒（HSV－Ⅰ）DNA，另选择25例非病毒性脑炎患者的脑脊液作为对照组。结果采用PCR扩增检测，检测阳性率为67％；采用巢式PCR扩增检测，检测阳性率为40％；25例非病毒性脑炎患者的脑脊液（对照组）经PCR和巢式PCR扩增，均未检出HSV-ⅠDNA。结论无论是PCR还是巢式PCR都具有高度的特异性；而在灵敏性方面，前者不如后者。表明PCR技术可有效地提高HSE的早期诊断水平，尤其是巢式PCR方法更有价值。

Obiective To compare the diagnostic value of two different polymerase chain reaction(PCR) in the early and rapid diagnosis of herpes simplex virus encephalitis.Methods We used PCR and nested PCR with different primers to detect herpes simplex virus - I (HSV - I) DNA in the cerebrospinal fluid(CSF) of 30 virus encephalitis (suspected HSE), 8 HSE(HSV - 1 - specific antibody positive confirmed by ELISA) and 25 control patients(non - encephalitis neurological cases). Results HSV - I DNA was found in 2/30 encephalitis by simple PCR, positive ratio is 6.7%; HSV- I DNA was found in 12/30 encephalitis by nested PCR, positive ratio is 40%. In & HSE, 1 HSV DNA was found by simple PCR and 6 HSV - I DNA by nested PCR. But it was not found in 25 control patients with other neurological diseases by either simple PCR or nested PCR. conclusion There is high specificity in both simple PCR and nested PCR. But nested PCR has higher sensitivity than simple PCR. It is suggested that the detection of HSV - I DNA in CSF using the nested PCR assay which we selected will be a better method of early and rapid diagnosis of acute HSE.