pp67-mRNA在移植术后人巨细胞病毒感染中的诊断价值

Clinical significance of expression of human cytomegalovirus pp67-mRNA in transplant recipients

目的 建立一种快速客观的人巨细胞病毒 (HCMV)活动性感染的新诊断方法。方法 采用核酸基础序列扩增法 (NASBA)测定移植术后患者外周血标本中巨细胞病毒信使核糖核酸 (pp67 mRNA) ,并与CMV抗原pp65检测法作比较 ,了解pp67的诊断价值。 结果 共检测移植术后患者 50例 ,pp65阳性患者 (≥ 1个 /5万WBC) 2 6例 ,其中pp67阳性患者 16例 ;有症状的CMV病患者 9例 ,pp65与pp67均为阳性 ;pp65阴性者中无pp67阳性。pp67的灵敏度、特异度、阳性预测值和阴性预测值分别为 10 0 %、82 %、56%和 10 0 %。结论 pp67 mRNA是实用客观的HCMV感染快速诊断方法 ,更准确的反映了HCMV的活动状况 。

ObjectiveTo establish a new method for diagnosis of active human cytomegalovirus (HCMV) i nfection and disease in transplant recipients.MethodsThe expression of HCMV pp67-mRNA in blood was detected by the nucleic acid sequence-based amplification (NASBA), in comparison to detection of pp65 HCMV a ntigen in white blood cells.ResultsIn 50 patients subject to transplantation, 26 were positive for pp65 (≥1/50 000 WBC). Among them, 16 were positive for pp67. In 9 cases of CMV with symptoms, b oth pp65 and pp67 were positive. In the patients negative for pp65, pp67 was not positive. The sensitivity, specificity, positive predictive value and negative predictive value were 100?%, 88?%, 56?% and 100?%, respectively.ConclusionDetection of pp67-mRNA by NASBA is a rapid objective and accurate approach for the diagnosis of HCMV infection.