巨细胞病毒抗原血症检测在肾移植术后的应用

Application of cytomegalovirus antigenemia detection in patients after renal transplantation

目的评估巨细胞病毒抗原血症检测方法对诊断肾移植患者巨细胞病毒感染的意义。方法收集2021年9月至2021年12月昆明市第一人民医院就诊90例肾移植患者的110例血样,对其进行巨细胞病毒(cytomegalovirus,CMV)pp65抗原血症检测与Ig G抗体、CMV DNA结果比较,评估CMV pp65抗原血症结果与肌酐、他克莫司(tacrolimus,Tac/FK506)药物浓度、淋巴细胞亚群的相关性。结果CMV pp65抗原血症结果与CMV DNA结果一致性为65.5%,差异具有统计学意义(P<0.05)。CMV pp65抗原血症检测结果与CMV IgG抗体检测结果一致性为57.3%,差异不具有统计学意义(P>0.05)。CMV pp65抗原血症结果与肌酐、FK506药物浓度比较,差异无统计学意义(P>0.05)。CMV pp65抗原血症结果与淋巴细胞亚群比较中,仅与NK细胞绝对值差异有统计学意义(P<0.05)。结论CMV pp65抗原与CMV IgG抗体结果一致性为57.3%。CMV pp65抗原与CMV DNA结果一致性为65.5%,两种方法联合检测,对提高CMV感染临床诊断准确率具有一定意义。在CMV pp65抗原阴性组与阳性组中,血清肌酐水平、全血FK506药物浓度两组间差异无统计学意义,NK细胞绝对值差异具有统计学意义,NK细胞绝对值偏高的肾移植患者,发生CMV感染的概率偏低。

Objective To evaluate the significance of detecting cytomegalovirus antigenemia in the diagnosis of cytomegalovirus infection in renal transplant patients.Methods From September 2021 to December 2021,a total number of 110 blood samples from 90 renal transplant patients in The First Hospital of Kunming were collected.The CMV pp65 antigenemia test was compared with the results of IgG antibody and CMV DNA.The correlation between the CMV pp65 antigenemia results and creatinine,tacrolimus(tacrolimus,Tac/FK506)concentration,lymphocyte subsets was evaluated.Results The consistency between CMV pp65 antigenemia results and CMV DNA results was 65.5%,the difference was statistically significant(P<0.05).The consistency between the CMV pp65 antigenemia test results and the CMV IgG antibody test results was 57.3%,the difference was not statistically significant(P>0.05).There was no significant difference between CMV pp65 antigenemia results and creatinine as well as FK506 drug concentrations(P>0.05).In the comparison between CMV pp65 antigenemia results and lymphocyte subsets,there was only a statistically significant difference between CMV pp65 and NK cell absolute value(P<0.05).Conclusion The consistency between CMV pp65 antigen and CMV IgG antibody was 57.3%.The consistency between CMV pp65 antigen and CMV DNA was 65.5%.The combined detection of CMV pp65 antigen and CMV DNA has certain significance in improving the accuracy of clinical diagnosis of CMV infection.There was no statistically significant difference in the serum creatinine level and the whole blood FK506 drug concentration between the CMV pp65 antigen negative group and the positive group.The absolute value difference of NK cells was statistically significant.The probability of CMV infection in renal transplant patients with high absolute value of NK cells was low.