婴儿肝炎综合征中人类巨细胞病毒感染检测方法的比较

Diagnosis of Human Cytomegalovirus Infection in Infantile Hepatitis Syndrome

目的:探讨婴儿肝炎综合征中人类巨细胞病毒(HCMV)感染的检测方法。方法:用HCMVpp65抗原血症法及荧光定量聚会酶链反应(FQ鄄PCR)法检测24例患儿34份血浆及多形核白细胞(PMNLs)标本。结果:HCMVpp65抗原血症法诊断巨细胞病毒感染所致婴儿肝炎综合征的特异度为100%,灵敏度为90%;FQ鄄PCR法检测PNNLs的特异度为100%,灵敏度为60%;血浆FQ鄄PCR法的特异度为100%,灵敏度为50%。同一份血标本其血浆中的HCMVDNA拷贝数低于PMNLs,使得血浆FQ鄄PCR法在HCMV诊断及疗效观察方面具有滞后现象。动态观察发现HCMVpp65抗原血症法与FQ鄄PCR法检测的PMNLs结果与婴儿肝炎综合征患儿的治疗过程有较好的符合率。结论:HCMVpp65抗原阳性与HCMV活动性感染密切相关,可作为婴儿肝炎综合征患儿疗效的观察指标。HCMVpp65抗原血症法与FQ鄄PCR法可作为临床诊断HCMV症状性感染的一种快速、有效的实验室方法。

To search for a method for detection of human cytomegalovirus(HCMV)infection in infantile hepatitis syndrome.Methods:HCMV pp65antigenemia assay and real time fluorescence quantitative polymerase chain reaction(FQ-PCR)were used to exam34plasma samples and polymorphonuclear leukocytes from24infant with hepatitis syn-drome.Results:The specificity and sensitivity of HCMV pp65antigenemia assay were100%and100%for detection of cytomegalovirus infection in infantile hepatitis syndrome.The specificity and sensitivity for detection of PMNLs were100%and60%with PMNLs FQ-PCR detection and100%and50%with plasma FQ-RCR.Plasma FQ-RCR had a delay in HCMV diagnosis and therapeutic effects observation because the copies of HCMV DNA was lower than PMNLs.Dynamic observation revealed that HCMV pp65antigenemia assay and PMNLs FQ-PCR accorded well with the treatment course of infantile hepatitis syndrome.Conclusion:HCMV pp65antigenicity is closely related with active HCMV infection and can be taken as an indicator of therapeutic effectiveness for infantile hepatitis syndrome;HCMC pp65antigenemia assay and FQ-PCR is a rapid and effective method for diagnosis of HCMV.