ARN患者房水VZV DNA和IgG抗体检测在抗病毒疗效评估中的价值

Role of VZV DNA and IgG antibody determinations in aqueous humor of ARN patients in evaluation of antiviral efficacy

目的 探讨接受抗病毒治疗的急性视网膜坏死(ARN)患者房水中水痘带状疱疹病毒(VZV)DNA载量和IgG抗体水平的动态变化,及其在疗效评估中的价值。方法 选取11例接受8周强化疗法的ARN患者,在确诊当天和治疗第4天、1周、2周、3周、4周和8周分别采集所有患者的房水100μL,分别检测VZV DNA载量和IgG抗体水平。采用Spearman秩相关分析评估病毒载量对数值与其他指标之间的相关性。结果11例ARN患者治疗前房水VZVDNA载量为(6.97±0.57)lg(拷贝/mL),随着抗病毒治疗时间的延长,患者房水VZV DNA载量整体呈下降趋势(P<0.000 1)。治疗8周后,11例ARN患者中有10例(90.91%)房水VZV DNA低于检测下限。11例ARN患者治疗前房水VZV IgG抗体水平(S/CO值)为4.84±1.72,与治疗前VZV DNA载量呈正相关(r=0.45,P<0.05)。接受抗病毒治疗后,ARN患者房水VZVIgG抗体水平呈下降趋势(P=0.001)。治疗8周时,11例ARN患者房水VZV IgG抗体水平虽显著低于治疗前(P=0.001),但仍均呈阳性。结论 8周强化疗法可有效降低ARN患者患眼中的VZV载量。VZV DNA载量检测可用于监测ARN病情的进展,反映抗病毒治疗效果。

Objective To investigate the dynamic changes of varicella-zoster virus(VZV) DNA load and IgG antibody level in aqueous humor of patients with acute retinal necrosis(ARN) who received antiviral treatment and the value in the evaluation of antiviral efficacy. Methods Totally,11 ARN patients receiving 8 weeks of intensive therapy were enrolled,and 100 μL of aqueous humor samples were collected once the patients were diagnosed and then on the 4th day,the 1st,2nd,3rd,4th and 8th weeks. VZV DNA load and VZV IgG antibody levels were determined. Spearman rank correlation analysis was used to evaluate the correlation between the logarithmic viral load and other indicators. Results The mean VZV DNA load in aqueous humor of 11 ARN patients before treatment was(6.97±0.57)lg(copies/mL). With the prolongation of antiviral treatment time,the VZV DNA load in aqueous humor showed an overall downward trend(P<0.000 1). After 8 weeks of treatment,10 of 11 patients(90.91%)had VZV DNA end up below the determination limit. The VZV IgG antibody level(S/CO value) in aqueous humor of 11 ARN patients was 4.84±1.72 before the treatment,which was positively correlated with the initial VZV DNA load(r=0.45,P<0.05). After receiving antiviral treatment,the level of VZV IgG antibody in aqueous humor of ARN patients showed a downward trend(P=0.001). Although the VZV IgG antibody level in aqueous humor of 11 ARN patients after 8 weeks of treatment was lower than that before treatment(P=0.001),it was still positive.Conclusions The 8-week intensive therapy effectively reduces the VZV load in the eyes of ARN patients. VZV DNA load determination can be used to monitor the progress of ARN disease and reflect the effect of antiviral treatment.