脐带血血浆在人巨细胞病毒垂直传播中的作用

The significance of umbilical cord blood plasma in the vertical transmission of human cytomegalovirus

目的了解合肥地区正常顺产新生儿先天性人巨细胞病毒(human cytomegalovirus,HCMV)感染情况,并探讨脐带血血浆在HCMV垂直传播中的意义。方法自合肥市妇幼保健院采集51份新生儿脐带血标本,将处理后得到的脐带血白细胞及血浆分别提取DNA后,进行HCMV UL55基因的巢式PCR检测,并随机抽取其中18份脐带血白细胞进行HCMV pp65抗原血症检测。结果 51份新生儿脐带血白细胞HCMV UL55 DNA阳性数为16份,阳性率为31.4%;同时进行检测的51份脐带血血浆HCMV UL55 DNA阳性数为17份,阳性率为33.3%,新生儿脐带血白细胞与血浆的标本阳性率差异无统计学意义(2=0.00,P=1.000)。以新生儿脐带血白细胞HCMVUL55 DNA巢式PCR结果为标准,利用血浆巢式PCR检测的灵敏度为75.0%(12/16),特异度为85.7%(30/35),阳性预测值为70.6%(12/17),阴性预测值为88.2%(30/34)。随机抽取其中18份新生儿脐带血白细胞进行pp65抗原血症检测,阳性标本数为6份,阳性率为33.3%;与此18份血浆DNA巢式PCR结果相比较,两者差异无统计学意义(2=0.00,P=1.000)。结论脐带血血浆在HCMV垂直传播中起携带并传播病毒的作用。

Objective To understand the neonatal congenital infection in Hefei and to investigate the significance of cord blood plasma in HCMV vertical transmission. Methods 51 cord blood were collected from a hospital of Maternal and Child Health. The DNA of leukocyte and plasma were extracted and detected by the nested PCR assay of HCMV UL55 gene. The cord blood leukocytes were detected by HCMV pp65 antigenemia. Results The HCMV positive number of the neonatal umbilical cord blood leukocyte DNA was 16, the positive rate was 31.4% ; the HCMV positive number of the neonatal umbilical cord blood plasma DNA were 17, the positive rate was 33.3%. Comparing the results of leucocyte and plasma specimens, the difference was not statistically significant（χ2= 0.00, P= 1. 000）. Using neonatal umbilical cord blood leukocyte HCMV nested PCR results as the standard, the sensitivity of HCMV DNA in plasma by nested PCR was 75.0% （12/16） , the specificity was 85.7% （30/35） , the positive predictive value was 70.6% （12/17） , and the negative predictive value was 88.2% （30/34）. 18 cord blood leukocytes were detected by pp65 antigenemia, the positive specimens number was 6, the positive rate was 33.3%. And compared with the results of the plasma DNA by nested PCR, the differ- ence was not statistically significant （ χ2 = 0.00, P = 1. 000）. Conclusions Plasma can carry and spread the virus in the vertical transmission of HCMV.