中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2011年
6期
731-733,737
,共4页
祝兴元%覃亚斌%马菊%郑素萍%李正秋%李梨平
祝興元%覃亞斌%馬菊%鄭素萍%李正鞦%李梨平
축흥원%담아빈%마국%정소평%리정추%리리평
病毒载量%巨细胞病毒感染/诊断
病毒載量%巨細胞病毒感染/診斷
병독재량%거세포병독감염/진단
Viral load%Cytomegalovirus infections/DI
目的 评估全血及尿液巨细胞病毒(CMV)载量检测在婴幼儿巨细胞病毒感染及判断预后的价值.方法 在血清学检测CMV-IgM或者CMV-IgG滴度≥40阳性患儿中筛选PP65抗原阳性CMV活动性感染婴幼儿50例,用更昔洛韦抗病毒治疗,一个疗程前后检测全血及尿液CMV荧光定量及治疗后PP65抗原.结果 治疗前全血CMV荧光定量阳性率98%,治疗后14%,PP65抗原阳性率6%,治疗前后全血荧光定量与PP65抗原检测差异无统计学意义(P＞0.05).治疗前尿液CMV荧光定量阳性率98%,治疗后90%,治疗前后尿液荧光定量与CMV感染临床特性不一致(P＜0.05,Sp＝0.11,PVP＝0.55,Youden指数＝0.09).结论 全血CMV荧光定量与PP65抗原有很好的相关性,可作为CMV活动性感染的指标;单独尿CMV荧光定量检测对区分CMV活动性和潜伏性感染及动态监测CMV治疗意义不大.
目的 評估全血及尿液巨細胞病毒(CMV)載量檢測在嬰幼兒巨細胞病毒感染及判斷預後的價值.方法 在血清學檢測CMV-IgM或者CMV-IgG滴度≥40暘性患兒中篩選PP65抗原暘性CMV活動性感染嬰幼兒50例,用更昔洛韋抗病毒治療,一箇療程前後檢測全血及尿液CMV熒光定量及治療後PP65抗原.結果 治療前全血CMV熒光定量暘性率98%,治療後14%,PP65抗原暘性率6%,治療前後全血熒光定量與PP65抗原檢測差異無統計學意義(P＞0.05).治療前尿液CMV熒光定量暘性率98%,治療後90%,治療前後尿液熒光定量與CMV感染臨床特性不一緻(P＜0.05,Sp＝0.11,PVP＝0.55,Youden指數＝0.09).結論 全血CMV熒光定量與PP65抗原有很好的相關性,可作為CMV活動性感染的指標;單獨尿CMV熒光定量檢測對區分CMV活動性和潛伏性感染及動態鑑測CMV治療意義不大.
목적 평고전혈급뇨액거세포병독(CMV)재량검측재영유인거세포병독감염급판단예후적개치.방법 재혈청학검측CMV-IgM혹자CMV-IgG적도≥40양성환인중사선PP65항원양성CMV활동성감염영유인50례,용경석락위항병독치료,일개료정전후검측전혈급뇨액CMV형광정량급치료후PP65항원.결과 치료전전혈CMV형광정량양성솔98%,치료후14%,PP65항원양성솔6%,치료전후전혈형광정량여PP65항원검측차이무통계학의의(P＞0.05).치료전뇨액CMV형광정량양성솔98%,치료후90%,치료전후뇨액형광정량여CMV감염림상특성불일치(P＜0.05,Sp＝0.11,PVP＝0.55,Youden지수＝0.09).결론 전혈CMV형광정량여PP65항원유흔호적상관성,가작위CMV활동성감염적지표;단독뇨CMV형광정량검측대구분CMV활동성화잠복성감염급동태감측CMV치료의의불대.
Objective To assess the value of CMV viral load test in the diagnosis and prognostic judgment of infantile cytomegalovirus infection with whole blood and urine specimens. Methods 50 infants with active CMV infection were selected, which pp65 antigen was positive in serological detection and either CMV-IgM positive or the titer of CMV-IgG ≥40. The viral load in whole blood and urine specimens was detected before and after a course of preemptive ganciclovir treatment and the pp65 antigen was determined after treatment. Results 98% patients were manifested as cytomegalovirus viral load quantitative measurement in whole blood positive before the treatment, while 14% after. The positive ratio of pp65 assay after therapy was 6%. And there was no significant difference between the results of the two kinds of detection methods measurement in urine before and after treatment was 98% and 90%, respectively. The results of urinary viral load quantitative detection did not coincide with clinical characteristics of CMV infection (P＜0.05,Sp＝0.11,PVP＝0.55, (Youden's index)＝0.09). Conclusions Good coincidence could be found between CMV-DNA quantitative measurement in whole blood and pp65 antigenemia assay. And the former could be used as a diagnostic index of CMV positive infection. While single urinary viral load quantitative detection had no significance for the distinction between active and latent CMV infection and dynamic monitoring of CMV treatment.
