不同年龄段患者中人巨细胞病毒的感染状况

Human cytomegalovirus infection status in patients of different ages

目的了解沈阳地区不同年龄段患者中人巨细胞病毒(HCMV)的感染状况。方法选择疑似HCMV感染患者123616例,采用荧光定量PCR技术检测HCMV DNA,化学发光免疫分析法检测血清HCMV IgM和IgG抗体,收集患者临床诊断信息。结果HCMV DNA、IgM抗体、IgG抗体阳性率分别为12.48%、2.34%、95.58%。>28 d~1岁组患儿HCMV DNA阳性率(31.52%)、IgM抗体阳性率(9.86%)最高。不同体液HCMV DNA阳性率不同,尿HCMV DNA阳性率(14.61%)大于血清(2.36%)和肺泡灌洗液(2.17%)。HCMV DNA阳性率与IgM抗体阳性率呈正相关,HCMV DNA阳性患者中,HCMV IgM抗体阳性者病毒载量高于IgM抗体阴性者。HCMV感染的临床诊断包括肺炎、神经系统损害、肝炎、血液病等。结论不同年龄段患者的HCMV感染状况存在差异。婴儿是HCMV易感人群,HCMV感染后主要累及肺脏、肝脏、神经系统等。多种体液样本HCMV DNA检测以及HCMV DNA与IgM抗体联合检测对HCMV检测和诊治有重要的意义。

Objective To investigate the status of human cytomegalovirus(HCMV)infection in patients of different ages.Methods A total of 123616 patients with suspected HCMV infection were included in this study.HCMV DNA was detected using fluorescence quantitative PCR,and serum HCMV IgM and IgG antibodies were determined by chemiluminescence immunoassay.The clinical diagnosis information was collected.Results The positive rates of HCMV DNA,IgM antibodies,and IgG antibodies were 12.48%,2.34%,and 95.58%,respectively.The positive rates of HCMV DNA(31.52%)and IgM antibodies(9.86%)were the highest in infants aged>28 d to 1 year.The rates differed in diverse bodily fluids;positive rate of HCMV DNA in urine was 14.61%,followed by that in serum(2.36%)and alveolar lavage fluid(2.17%).The positive rate of HCMV DNA was positively correlated with that of IgM antibodies.Among HCMV DNA positive patients,the viral load in HCMV IgM antibodies positive group was higher than that in IgM antibodies negative group.Clinical diagnosis of HCMV infection in patients included pneumonia,nervous system damage,hepatitis,and blood diseases.Conclusion The HCMV infection status differed in patients of different ages.Infants were more susceptible to HCMV.It mainly affected the lungs,liver,and nervous system.The detection of HCMV DNA in diverse samples and the combined detection of HCMV DNA and IgM antibodies were significant in the detection,diagnosis,and treatment of HCMV.