中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2010年
3期
377-379
,共3页
李广云%杨吉伟%门同义%王建宁%李现铎%张晓明%孟红
李廣雲%楊吉偉%門同義%王建寧%李現鐸%張曉明%孟紅
리엄운%양길위%문동의%왕건저%리현탁%장효명%맹홍
肾移植%巨细胞病毒%浓缩尿%荧光定量PCR
腎移植%巨細胞病毒%濃縮尿%熒光定量PCR
신이식%거세포병독%농축뇨%형광정량PCR
Renal transplantation%Cytomegalovirns%Urinary concentration%Fluorescence quantitative polymerase chitin reaction
目的 通过与原尿沉渣、血浆标本比较人巨细胞病毒DNA(HCMV-DNA)含量的差异,评估二次浓缩尿沉渣在监测肾移植术后HCMV感染的应用价值.方法 将165例肾移植患者血浆、原尿沉渣和二次浓缩尿沉渣标本用荧光定量PCR(FQ-PCR)方法 检测肾移植前、移植后、抗病毒治疗过程中HCMV-DNA拷贝数,二次浓缩尿标本与原尿沉渣监测HCMV-DNA均阳性组进行更昔洛韦(GCV)抗病毒干预,采用卡方检验和秩和检验方法 进行组间比较.结果 165例肾移植患者术前血浆、原尿沉渣和二次浓缩尿沉渣标本中均未检测到HCMV-DNA;术后原尿沉渣中检出率25.45%,浓缩尿沉渣中检出率38.79%,差异有统计学意义(x~2=6.727,P＜0.01),血浆检出率18.18%,与二次浓缩尿组比较,差异有统计学意义(χ~2=8.598,P＜0.01);同一时间点浓缩尿HCMV-DNA检出的病毒拷贝数均高于原尿,差异有统计学意义(U=4.772,P＜0.01);二次浓缩尿比原尿标本检出HCMV-DNA早7～14 d,HCMV.DNA检出高峰均集中于术后第6～8周.施加临床干预患者浓缩尿HCMV-DNA拷贝数显著下降、或调整干预方案后下降.结论 二次浓缩尿沉渣方法 能明显缩短HCMV-DNA检出时间,提高阳性检出率,能及时有效地为临床提供诊断和治疗依据,尤其在监测肾移植术后HCMV感染中具有临床应用价值.
目的 通過與原尿沉渣、血漿標本比較人巨細胞病毒DNA(HCMV-DNA)含量的差異,評估二次濃縮尿沉渣在鑑測腎移植術後HCMV感染的應用價值.方法 將165例腎移植患者血漿、原尿沉渣和二次濃縮尿沉渣標本用熒光定量PCR(FQ-PCR)方法 檢測腎移植前、移植後、抗病毒治療過程中HCMV-DNA拷貝數,二次濃縮尿標本與原尿沉渣鑑測HCMV-DNA均暘性組進行更昔洛韋(GCV)抗病毒榦預,採用卡方檢驗和秩和檢驗方法 進行組間比較.結果 165例腎移植患者術前血漿、原尿沉渣和二次濃縮尿沉渣標本中均未檢測到HCMV-DNA;術後原尿沉渣中檢齣率25.45%,濃縮尿沉渣中檢齣率38.79%,差異有統計學意義(x~2=6.727,P＜0.01),血漿檢齣率18.18%,與二次濃縮尿組比較,差異有統計學意義(χ~2=8.598,P＜0.01);同一時間點濃縮尿HCMV-DNA檢齣的病毒拷貝數均高于原尿,差異有統計學意義(U=4.772,P＜0.01);二次濃縮尿比原尿標本檢齣HCMV-DNA早7～14 d,HCMV.DNA檢齣高峰均集中于術後第6～8週.施加臨床榦預患者濃縮尿HCMV-DNA拷貝數顯著下降、或調整榦預方案後下降.結論 二次濃縮尿沉渣方法 能明顯縮短HCMV-DNA檢齣時間,提高暘性檢齣率,能及時有效地為臨床提供診斷和治療依據,尤其在鑑測腎移植術後HCMV感染中具有臨床應用價值.
목적 통과여원뇨침사、혈장표본비교인거세포병독DNA(HCMV-DNA)함량적차이,평고이차농축뇨침사재감측신이식술후HCMV감염적응용개치.방법 장165례신이식환자혈장、원뇨침사화이차농축뇨침사표본용형광정량PCR(FQ-PCR)방법 검측신이식전、이식후、항병독치료과정중HCMV-DNA고패수,이차농축뇨표본여원뇨침사감측HCMV-DNA균양성조진행경석락위(GCV)항병독간예,채용잡방검험화질화검험방법 진행조간비교.결과 165례신이식환자술전혈장、원뇨침사화이차농축뇨침사표본중균미검측도HCMV-DNA;술후원뇨침사중검출솔25.45%,농축뇨침사중검출솔38.79%,차이유통계학의의(x~2=6.727,P＜0.01),혈장검출솔18.18%,여이차농축뇨조비교,차이유통계학의의(χ~2=8.598,P＜0.01);동일시간점농축뇨HCMV-DNA검출적병독고패수균고우원뇨,차이유통계학의의(U=4.772,P＜0.01);이차농축뇨비원뇨표본검출HCMV-DNA조7～14 d,HCMV.DNA검출고봉균집중우술후제6～8주.시가림상간예환자농축뇨HCMV-DNA고패수현저하강、혹조정간예방안후하강.결론 이차농축뇨침사방법 능명현축단HCMV-DNA검출시간,제고양성검출솔,능급시유효지위림상제공진단화치료의거,우기재감측신이식술후HCMV감염중구유림상응용개치.
Objective To evaluate the clinical value of dynamic surveillance of human cytomegalovirus(HCMV)-DNA in second urinary concentration for diagnosis of HCMV infection.Methods Thesamples of blood,primary urine and second urinary concentration were all seriously collected from 165 rehal transplant recipients and the viral load was detected by fluorescent quantitative polymeraee chain njaction polymerase chain reaction(FQ-PCR).The patients positive for HCMV-DNA in primary urine and urinary concentration were all treated by ganeielovir.Results All the samples pre-operation were negative.Positive rate of HCMV-DNA in blood,primary urine and urinary eoncemmtion wag 18.18%,25.45%and 38.79%,respectively(P＜0.01).The viral load and positive rate of urinary concentration were higher than primary urine(U=4.772,P＜0.01).The peak of HCMV-DNA appeared from the sixth to eighth week after operation.The viral 10ad of urinary concentration was significantly declined or descended by adjnsting the dose of ganeiclovir based on the GFR.Conclusion Second urinary concentration not only obvionsly shortens the detection time and increases the positive rate.but also provides the scientific proof for clinicM prognosis and treantmen,especially it has important clinical price for dynamic surveillance of HCMV infeetion.
