利用ELISA与荧光定量PCR技术筛查新生儿巨细胞病毒感染水平及探讨与肝脏损害的相关性

Screen of Cytomegalovirus in Neonates by Using ELISA and qPCR and Investigation Correlation of Cytomegalovirus in Liver Function Damage

目的:了解目前淄博地区新生儿感染巨细胞病毒(HCMV)的现状,找出最佳检测方法,提高诊断水平,并探讨巨细胞病毒对肝功能的损害。方法:采用抗体捕获酶联免疫吸附试验(ELISA)及荧光定量PCR(qPCR)对2011年12月至2012年5月出生的2596例新生儿分别进行血清HCMV-IgM抗体和尿液HCMV-DNA定量检测,并对符合HCMV感染的阳性标本进行肝功能回顾性分析。结果:用ELISA检测血清CMV-IgM阳性29例(1.117%),用qPCR检测尿液HCMV-DNA阳性39例(1.502%),两种方法阳性符合率71.79%,差异有统计学意义(P<0.01);共有40例阳性患儿回顾性分析肝功能指标血清总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)均高于正常值,差异均有统计学意义(P<0.05)。结论:淄博地区新生儿巨细胞病毒感染率较高,危害性大,对新生儿早期检测和诊断十分重要,定量荧光PCR法检测敏感性要高于ELISA法检测,具有良好的应用价值;检测出的HCMV感染患儿肝脏易受病毒侵害,造成肝功能损害。

Objective： To explore the infection of cytomegalovirus in neonates of Zibo area and find the best testing method for di- agnose, to investigate the damage of liver function. Methods： 2596 neonatal cases in our hospital fxom December, 2011 to May, 2012 were collected. The serum HCMV IgM and urine HCMV DNA of neonates were detected by enzyme-linked immunosorbent assay and fluorescent quantitative PCR, respectively. Results： In all cases, 29 cases were positive detected with serum CMV IgM （1.117%） by ELISA, 39 cases were positive detected with urine HCMV DNA （1.502%） by qPCR. The coincidence rate of detection was 71.97% in two methods, there was significant difference （P〈0.01）; Liver function indicator in 40 positive children were analyzed retrospectively, in- cluding serum total bilirubin （TBIL）, alanine transaminase （ALT）, aspartate amino-transferase （AST）, glutamyl transpeptidase （GGT）. The level of these indicator were higher than normal value, which showed significant difference . （P〈0.05）. Conclusion： The cy- tomegalovirus infection rate in neonates of Zibo area is very high, which indicated that HCMV is harmful to neonates, fast and efficient detection method is very important for early diagnosis. Fluorescent quantitative PCR is more sensitive than ELISA in HCMV detection. HCVM infection children are invaded easily, which lead to injured liver function.