巨细胞病毒抗体和DNA联合诊断婴幼儿巨细胞病毒肝炎

Combined diagnosis of infant cytomegalovirus hepatitis with cytomegalovirus antibody and DNA

目的比较单独和联合检测巨细胞病毒抗体和脱氧核糖核酸(DNA)诊断婴幼儿巨细胞病毒肝炎的价值。方法选择嘉兴学院附属妇女儿童医院2016年1月至2019年6月收治的96例巨细胞病毒肝炎患儿为观察组,62例同期无感染症状健康婴幼儿为对照组。比较两组婴幼儿血清巨细胞病毒IgM抗体阳性率和尿液巨细胞病毒DNA阳性率,并比较观察组不同症状、年龄的患儿巨细胞病毒抗体和DNA阳性率的差异,同时评价巨细胞病毒抗体和DNA单独和联合检测对婴幼儿巨细胞病毒肝炎的诊断效能。结果观察组血清巨细胞病毒IgM抗体阳性率比对照组明显升高(χ^2=92.54,P<0.01)。观察组不同症状的患儿血清巨细胞病毒IgM抗体阳性率和尿液巨细胞病毒DNA阳性率之间均无统计学差异(χ^2=3.89,P>0.05;χ^2=6.39,P>0.05)。观察组不同年龄分组患儿血清巨细胞病毒IgM抗体阳性率和尿液巨细胞病毒DNA阳性率之间均无统计学差异(χ^2=1.32,P>0.05;χ^2=6.65,P>0.05)。联合检测巨细胞病毒IgM抗体和DNA诊断婴幼儿巨细胞病毒肝炎的敏感度为94.12%,特异度为81.82%,阳性预测值为97.56%,阴性预测值为64.29%,准确度为92.71%。结论联合检测血清巨细胞病毒IgM抗体和尿液巨细胞病毒DNA相比单独检测对婴幼儿巨细胞病毒肝炎的诊断效能明显升高,提示联合检测对该病具有较高的诊断价值。

Objective To compare the diagnostic value of cytomegalovirus antibody or deoxyribonucleic acid(DNA) alone and in combination for infants and young children with cytomegalovirus hepatitis.Methods 96 cases of cytomegalovirus hepatitis treated in Jiaxing College Affiliated Women and Children’s Hospital from January 2016 to June 2019 were selected as the observation group,and 62 cases of healthy infants without infection symptoms were selected as the control group.The positive rates of serum cytomegalovirus IgM antibody and urine cytomegalovirus DNA were compared between the two groups.The differences of cytomegalovirus antibody and DNA positive rates among children with different symptoms and ages in the observation group were compared,and the diagnostic efficacy of cytomegalovirus antibody and DNA detection alone or in combination for cytomegalovirus hepatitis in infants and young children was evaluated.Results Compared with the control group,the positive rate of serum cytomegalovirus IgM antibody in the observation group was significantly increased(χ^2=92.54,P<0.01).There was no significant difference in the positive rate of serum cytomegalovirus IgM antibody and urine cytomegalovirus DNA among children with different symptoms in the observation group(χ^2=3.89 and 6.39,respectively,both P>0.05).And no significant differences were found in the positive rate of serum cytomegalovirus IgM antibody and urine cytomegalovirus DNA among children of different age groups in the observation group(χ^2=1.32 and 6.65,respectively,both P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of combined detection of cytomegalovirus IgM antibody and DNA in the diagnosis of infant cytomegalovirus hepatitis were 94.12%,81.82%,97.56%,64.29% and 92.71%,respectively.Conclusions Compared with the single detection,the combined detection of cytomegalovirus antibody and DNA in the diagnosis of infant cytomegalovirus hepatitis is significantly higher,suggesting that the combined detection of cytomegalovirus IgM antibody in blood and cytomegalovirus DNA in urine has a high diagnostic value.