急性期带状疱疹患者不同标本中水痘-带状疱疹病毒的检测研究

Detection of varicella-zoster virus in different specimens from patients with acute herpes zoster

目的探讨急性期带状疱疹患者血液、唾液、皮疹、接触皮疹处衣物中水痘-带状疱疹病毒(VZV)DNA阳性率及其临床意义。方法选取2019年4月至2020年8月在南方医科大学深圳医院皮肤科确诊的带状疱疹患者为研究对象。采用荧光定量PCR检测患者抗病毒治疗前后血液、唾液、皮疹和接触皮疹处衣物中VZV DNA,用χ^(2)检验比较头面颈部与非头面颈部带状疱疹患者唾液标本中VZV DNA阳性率,分析治疗前后不同标本VZV DNA阳性率的变化。结果共纳入86例带状疱疹患者,其中男26例,女60例,年龄(52.65±14.83)岁,病程(5.23±2.10)d。24例头面颈部带状疱疹患者唾液标本中10例(41.67%)VZV DNA阳性,62例非头面颈部带状疱疹患者中8例(12.90%)阳性,两组比较,χ^(2)=7.63,P<0.05。治疗前后,37例采集了血液标本,35例采集了唾液标本,28例采集了皮疹标本,27例采集了接触皮疹处衣物标本。治疗前,血液、唾液、皮疹、接触皮疹处衣物标本中VZV DNA阳性分别为32例(86.49%)、8例(22.86%)、26例(92.86%)、24例(88.89%),治疗(6.82±2.23)d后,这4种标本的VZV DNA阳性率分别下降为51.35%、8.57%、89.29%、85.18%,仅血液标本治疗前后VZV DNA阳性率差异有统计学意义(χ^(2)=9.60,P=0.003),其余标本阳性率差异均无统计学意义(均P>0.05)。结论急性期头面颈部带状疱疹患者唾液VZV DNA阳性率高于其他部位患者;抗病毒治疗前后衣物处VZV DNA阳性率均较高。

Objective To investigate positive rates of varicella-zoster virus(VZV)DNA in blood and saliva samples,as well as in swab samples from lesions and clothes in contact with lesions in patients with acute herpes zoster,and to explore their clinical significance.Methods Patients with confirmed herpes zoster were collected from Department of Dermatology,Shenzhen Hospital,Southern Medical University from April 2019 to August 2020.Fluorescence-based quantitative PCR was performed to detect VZV DNA in blood and saliva samples,lesion and cloth swab samples from the patients before and after antiviral treatment.Chi-square test was used to compare the positive rate of VZV DNA in saliva samples between patients with herpes zoster on the head,face and neck and those without involvement of the head,face or neck,and changes in the positive rate of VZV DNA in different specimens were analyzed before and after treatment.Results A total of 86 patients with herpes zoster were collected,including 26 males and 60 females aged 52.65±14.83 years,with a disease duration being 5.23±2.10 days.The positive rate of VZV DNA in the saliva samples was significantly higher in the 24 patients with herpes zoster on the head,face and neck(41.67%,10/24)than in the 62 patients without involvement of the head,face or neck(12.90%,8/62;χ^(2)=7.63,P<0.05).Both pre-and post-treatment blood samples were collected from 37 patients,saliva samples from 35,lesion swab samples from 28,and cloth swab samples from 27.Before the treatment,the positive rates of VZV DNA in the blood,saliva,lesion and cloth swab samples were 86.49%(32/37),22.86%(8/35),92.86%(26/28)and 88.89%(24/27)respectively,which decreased to 51.35%,8.57%,89.29%and 85.18%,respectively,after 6.82±2.23 days of treatment.The positive rate of VZV DNA significantly differed before and after treatment only in the blood samples(χ^(2)=9.60,P=0.003),while showed no significant difference in the other specimens(all P>0.05).Conclusion The positive rate of VZV DNA in the saliva samples was significantly higher in the patients with acute herpes zoster on the head,face and neck than in those without involvement of the head,face or neck,and that in the cloth swab samples was relatively high before and after antiviral treatment.