CAJ | 학술논문

目的探讨尿液上皮细胞(EC)中人巨细胞病毒(HCMV)DNA载量预测婴儿活动性HCMV感染的应用价值.方法分别收集82例HCMV潜伏感染组和84例活动性感染组婴儿外周血和尿液标本,采用实时荧光定量聚合酶链反应(FQ-PCB)和化学发光免疫分析检测血浆HCMV DNA载量和HCMV IgM/IgG抗体;间接免疫荧光法检测外周血多形核白细胞(PMNLs)中HCMV pp65抗原;UF-100尿沉渣全自动分析仪和FQ-PCR分别做尿液EC计数和HCMV DNA载量检测,并计算尿液EC中HCMV DNA载量.同时,用受试者工作特征曲线(ROC)评价尿液上皮细胞中HCMV DNA载量在婴儿HCMV激活感染诊断中的敏感度和特异度.结果 166例HCMV感染婴儿尿液上皮细胞中HCMV DNA阳性检出率最高,为94.58%(157/166),病毒载量范围为5.67×102-1.31×107拷贝/103EC;不同时段尿液EC中HCMV DNA载量差异无统计学意义(F=0.19,P>0.05);活动性感染组尿液EC中HCMV DNA载量[5.13±0.99(拷贝/103EC,lg)]显著高于潜伏感染组[3.92±0.82(拷贝/103EC,lg),t=8.52,P<0.01];根据ROC曲线,当cut-off值为4.55时,尿液EC中HCMV DNA载量对活动性感染诊断的敏感度和特异度分别为71.4%和75.2%;活动性感染患儿更昔洛韦治疗后尿液EC中HCMV DNA载量显著低于治疗前(t=5.44,P<0.01).结论尿液EC中HCMV DNA载量用于预测婴儿HCMV活动性感染是一种简便、有效的方法,并能用于治疗监测.
목적 탐토뇨액상피세포(EC)중인거세포병독(HCMV)DNA재량예측영인활동성HCMV감염적응용개치.방법 분별수집82례HCMV잠복감염조화84례활동성감염조영인외주혈화뇨액표본,채용실시형광정량취합매련반응(FQ-PCB)화화학발광면역분석검측혈장HCMV DNA재량화HCMV IgM/IgG항체;간접면역형광법검측외주혈다형핵백세포(PMNLs)중HCMV pp65항원;UF-100뇨침사전자동분석의화FQ-PCR분별주뇨액EC계수화HCMV DNA재량검측,병계산뇨액EC중HCMV DNA재량.동시,용수시자공작특정곡선(ROC)평개뇨액상피세포중HCMV DNA재량재영인HCMV격활감염진단중적민감도화특이도.결과 166례HCMV감염영인뇨액상피세포중HCMV DNA양성검출솔최고,위94.58%(157/166),병독재량범위위5.67×102-1.31×107고패/103EC;불동시단뇨액EC중HCMV DNA재량차이무통계학의의(F=0.19,P>0.05);활동성감염조뇨액EC중HCMV DNA재량[5.13±0.99(고패/103EC,lg)]현저고우잠복감염조[3.92±0.82(고패/103EC,lg),t=8.52,P<0.01];근거ROC곡선,당cut-off치위4.55시,뇨액EC중HCMV DNA재량대활동성감염진단적민감도화특이도분별위71.4%화75.2%;활동성감염환인경석락위치료후뇨액EC중HCMV DNA재량현저저우치료전(t=5.44,P<0.01).결론 뇨액EC중HCMV DNA재량용우예측영인HCMV활동성감염시일충간편、유효적방법,병능용우치료감측.
Objective To investigate the application value for predicting human cytomegalovirus(HCMV) infection with viral load in urinary epithehal cell (EC).Methods Peripheral blood and urine specimens from 82 infants with HCMV latent infection and 84 infants with HCMV active infection were collected respectively.Plasma HCMV DNA load and the levels of HCMV lgM/IgG antibody were detected by real-time fluorescence quantitative polymernse chain reaction (FQ-PCR) and chemiluminescence immunsassay.HCMV pp65 antigen in peripheral blood polymorphonuclear leukocytes (PMNLs) was detected by indirect immunofluorescence assay.The urinary EC count and HCMV DNA load were detected by UF-100 automated urine sediment analyzer and FQ-PCR,respectively.HCMV DNA load in urinary EC was calculated accordingly.At the same time,the sensitivity and specificity for diagnosis of active HCMV infection were evaluated by receiver operating characteristic curve (ROC).Results The positivity of HCMV DNA in urinary EC was 94.58% (157/166),which was the highest among the urinary EC from 166 cases of HCMV infection.HCMV DNA load ranged from 5.67×102to 1.31×107 copies/103 EC There was no significantly statistical difference among urine specimens from different periods of time(P>0.05).HCMV DNA load in active infection group [5.13±0.99(copies/103EC,lg)]is significantly higher than that in latent infection group [3.92±0.82 (copies/103 EC,lg),t = 8.52,P < 0.01];According to ROC curve analysis,its sensitivity and specificity were 71.4% and 75.2% respectively when cut-off value was 4.55.The virus load was significantly decreased in urinary EC in post-treatment infants as compared with pre-trestment(t=5.44,P<0.01).Conclusion Detection of HCMV DNA load in the urinary EC is a cost-effective method and can be used to predict HCMV active infection in infants and monitor treatment of HCMV infection.