慢性结膜炎患者泪液中腺病毒与单纯疱疹病毒的检测分析

Detection and analysis of adenovirus and herpes simplex virus （HPV） in the tears of patients with chronic conjunctivitis

目的探讨腺病毒和单纯疱疹病毒在慢性结膜炎患者泪液中的分泌情况，为临床诊断提供参考。方法收集慢性结膜炎患者、急性病毒性结膜炎患者及健康体检者的泪液标本，采用聚合酶链反应（PCR）法检测三组患者泪液标本腺病毒和单纯疱疹病毒核酸，并进行对比分析。观察腺病毒或单纯疱疹病毒阳性患者的临床症状。结果慢性结膜炎组标本中腺病毒与单纯疱疹病毒核酸阳性率分别为48．5％（33／68）和17．6％（12／68）。慢性结膜炎组有明确既往急性结膜炎病史的患者中腺病毒核酸阳性率为62．5％（15／24），高于无既往病史组（20．0％），差异有统计学意义（P〈0．01）；有既往病史的慢性结膜炎患者的单纯疱疹病毒感染阳性（29．2％）率亦高于无既往病史者（15．0％）（P〈0．05）。急性结膜炎组患者的泪液中腺病毒和单纯疱疹病毒的核酸阳性率分别为100．O％（15／15）和86．7％（13／15），健康对照组标本中两种病毒核酸的检测结果全部为阴性。眼红、眼痒、下睑滤泡是感染以上两种病毒感染的主要临床表现。结论腺病毒和单纯疱疹病毒在慢性结膜炎患者中的阳性率差异不明显。但有既往感染史患者上述两种病毒的阳性率显著高于无既往感染史患者，下睑滤泡症状对评估是否存在病毒感染有一定的参考价值。

Objective To investigate the expression of adenovirus and HPV in the tears of chronic conjunctivitis patients and provide the guidance for the clinical diagnosis. Methods Collecting the tears from patients with chronic conjunctivitis, acute viral conjunctivitis and healthy volunteers, polymerase chain reaction （PCR） was used to test the DNA of adenovirus and HPV. The positive rate of each group was com- pared. The symptoms of patients with adenovirus and HPV infection were analyzed. Results The positive rate of adenovirus and HPV in patients with chronic conjunctivitis was 48.5% （33/68） and 17. 6% （12/ 68 ） respectively. Among them, the patients with acute viral conjunctivitis history had a positive rate of ade- novirus of 62. 5% （15/94）, which was higher than that of patients without acute viral conjunctivitis history, and there was significant difference between them （P 〈 0. 01 ）. The same trend was found when comparing the positive rate of HPV between the patients with acute viral conjunctivitis history （29. 2% ） and without this history （ 15.0% ）, and there was significant difference between them （ P 〈 0.05 ）. The positive rate of adenovirus and HPV in patients with acute viral conjunctivitis was 100.0% （15/15） and 86. 7% （13/15） re- spectively, while norie of these two viruses were detected in specimens of ilealthy volunteers. Redness, itch- ing of eyes and the lower eyelid follicular were the main symptoms in the patients with adenovirus and HPV infection. Conclusions There is no significant difference in the positiw rate of adenovirus and HPV between adults and children chronic conjunctivitis patients. Patients who have acute viral conjunctivitis history are more likely to be tested positive of adenovirus and HPV comparing to patients without acute viral conjunctivitis history. The symptom of lower eyelid follicular is essential in the diagnosis of viral conjunctivitis.