巨细胞病毒感染与炎症性肠病相关性研究

Correlation of Cytomegalovirus Infection in the Intestine of Patients with Inflammatory Bowel Disease

目的:从CMV基因水平观察巨细胞病毒(cytomegalovirus,CMV)感染与炎症性肠病(inflammatory bowel disease,IBD)的相关性。方法:我们从2007～2010年.对76例溃疡性结肠炎(ulcerative colitis,UC)52例,克罗恩病(Crohn's disease,CD)24例的成人患者进行研究,研究CMV感染者肠道病理标本及其血液的分子水平、肠道组织标本免疫组化,以40例非炎症性肠病者作为对照组。结果:免疫组化着色显示CMV抗原阳性9例(7例是UC、8例是严重IBD病例),对照组CMV抗原均阴性。PCR-CMV基因在全部IBD肠组织标本、血液中均阳性有23(30.3%)例,16(30.8%)例为UC,7(25.9%)例为CD。此外,5(6.6%)例IBD中(2例UC,3例CD)在肠道组织检测到CMV基因,而在血液中未检测到。在对照组,5(12.5%)例血液中检测到CMV基因,仅1例(2.5%)在肠道组织检测到CMV基因。结论:UC与对照组相比,更易检测到CMV(在血液和肠道组织样本)(P=0.034和P<0.0001),而CD患者与对照组相比,更易在肠道组织标本检测CMV基因(P=0.002),在血液或肠道检测到CMV基因与IBD持续时间明显相关(P=0.004和0.03),但与年龄、性别、疾病的严重程度、结肠镜下的活动性、全结肠炎、需要特殊治疗和外科手术无关。在本研究中,检测到肠道CMV基因或抗原常与IBD有关。

objective：To observe the correlation between HCMV infection and inflammatory bowel disease from the gene level of HCM..Methods：A cross-sectional prospective study was conducted between September 2007 and June 2010 in a cohort of 76 patients diagnosed with IBD（52 with ulcerative colitis and 24 with Crohn＇ s disease） in two adult gastrointestinal.Prevalence of CMV infection was estimated by pathologic studies in intestinal sections and by molecular assays in blood and intestinal tissue samples and compared with a control group of 40 individuals with noninflammatory disease.Results：Immunohistochemical staining showed CMV antigen in 9 IBD patients（7 with ulcerative colitis：8 with severe disease）,whereas CMV antigen was not detected in any of the controls.CMV genome in both the intestinal tissue and blood was found by polymerase chain reaction in 23（30.3%） of the total IBD patients,in 16（30.8%） of those with ulcerative colitis.and in 7（25.9%） of those with Crohn＇ s disease.In addirion,five（6.6%） IBD patients（2 with ulcerative colitis and 3 with Crohn＇ s disease） had detectable CMV genome in their intestinal samples but not in their blood.In the control group,five（12.5%） individuals had detectable CMV genome in their blood,but only one（2.5%） in his intestine.Concinsion：Patients with ulcerative colitis had more often detectable CMV genome in their blood as well as in their intestinal tissue samples as compared with controls（P= 0.034 and P0.0001,respectively）.However,patients with Crohn＇ s disease had more often detectable CMV genome only in their intestinal tissue samples as compared with controls（P=0.002）.Detection of CMV genome in blood or intestinal tissue was significantly associated with short duration of IBD（P= 0.004 and 0.03,respectively） but not with age,sex,severity of the disease,activity at colonoscopy,pancolitis,admi nistration of a specific treatment.and surgery.In this cross-sectional prospective study,detection of CMV genome or antigen in the intestine was commonly associated with IBD.