UL37x3检测在新生儿晚期黄疸巨细胞病毒感染诊断中的应用

Application of detection of UL37 exon 3 gene in diagnosis of human cytomegalovirus infection in late jaundice infants

目的探讨UL37外显子3（UL37x3）基因检测在新生儿晚期黄疸巨细胞病毒（Human cytomegalovirus,HCMV）感染诊断中的应用。方法应用巢式PCR法检测2012年1~12月在新生儿科就诊的新生儿晚期黄疸标本UL37x3基因,并通过与HCMV-Ig M、HCMV-DNA荧光定量PCR、HCMV-pp65抗原检测结果做比较,分析UL37x3基因检测在诊断新生儿晚期黄疸HCMV感染的符合程度。结果 ① 145例新生儿晚期黄疸血清HCMV-Ig M检测阳性1例,HCMV荧光定量PCR检测阳性24例,HCMV-pp65抗原阳性25例,UL37x3基因扩增阳性25例;② UL37x3基因检测与HCMV-DNA荧光定量PCR检测结果差异无统计学意义（P=1.000）,一致率为96.6%,κ值为0.877;UL37x3基因检测与HCMV-pp65抗原检测结果差异无统计学意义（P=1.000）,一致率为95.9%,κ值为0.855;③ UL37x3基因检测用于诊断新生儿晚期黄疸HCMV感染的灵敏度为88.9%,特异度为99.2%,Youden指数为0.88;阳性预测值和阴性预测值分别为0.960和0.975;4 UL37x3基因检测用于诊断新生儿晚期黄疸HCMV活动性感染的灵敏度为88.0%,特异度为97.5%,Youden指数为0.85;阳性预测值和阴性预测值分别为0.880和0.975。结论 UL37x3基因检测适用于临床新生儿晚期黄疸HCMV感染的诊断。

Objective To diagnose human cytomegalovirus infection in late jaundice infants by detection of UL37 exon 3（UL37x3） gene. Methods Nested PCR was performed to amplify the UL37x3 gene region of clinical strains collected fromlate jaundice infants, the results were compared with that of serum HCMV- Ig M,HCMV- DNA PCR and HCMV- pp65 antigenemia assay and the coincidence degree of the results in detection of human cytomegalovirus strains collected from latejaundice infants was analyzed. Results One hundred and forty-five serum samples of late jaundice infants were detected, onewas positive by HCMV-Ig M, 24 were positive by PCR HCMV-DNA, 25 were positive by HCMV-pp65 and 25 were positiveby UL37x3 gen amplification.There was no significant difference in detection of HCMV infection by UL37x3 gene and PCRHCMV-DNA（ P = 1.000）. The coincidence rate of UL37x3 gene and HCMV-DNA PCR was 96.6% and the value of Kappawas 0.877; There was no significant difference in detection of HCMV infection between UL37x3 gene and HCMV-pp65（P =1.000）. The consistent rate of UL37x3 gene and HCMV-pp65 was 95.9% with Kappa value of 0.855. The sensitivity of UL37x3 gene in detection of HCMV infection in late jaundice infants was 88.9%, the specificity was 99.2% with Youden index of 0.88,the positive predictive value and negative predictive value were 0.960 and 0.975,respectively. The sensitivity and specificity ofdetection of UL37x3 gene in diagnosis of active HCMV infection in late jaundice infants were 88.0% and 97.5% with Youdenindex of 0.85, the positive predictive value and negative predictive value were 0.880 and 0.975 respectively. Conclusions Detection of UL37x3 gene is suitable for diagnosis of HCMV infection in late jaundice infants.