CAJ | 학술논문

目的：应用实时荧光定量聚合酶链反应（ FQ-PCR）检测疑似人巨细胞病毒（ HCMV）感染的患儿尿液、血液及对应母亲乳汁中HCMV DNA含量，探讨其在HCMV感染诊断中的价值及对肝脏损伤情况。方法应用FQ-PCR方法检测104例疑似HCMV感染患儿新鲜尿液上皮细胞、血液及其对应的母亲乳汁中的HCMV DNA拷贝数，并同时检测患儿血液中天冬氨酸转氨酶（ AST）、丙氨酸转氨酶（ ALT）、谷氨酰转肽酶（GGT）、总胆红素水平。结果尿液、血液标本阳性检出率分别为52．9％（55/104），24．0％（25/104），尿液阳性率明显高于血液阳性率，二者差异有统计学意义（P＜0．01）。乳汁标本阳性检出率为81．7％（85/104），对应患儿血液和/或尿液阳性率为62．4％（53/85），二者差异有统计学意义（P＜0．05）。且患儿HCMV拷贝数越高，肝脏损伤的可能性越大。结论婴儿尿液中HCMV DNA检测率明显高于血液的检出率，且拷贝数越高，肝功能损伤的可能性就越大。尿液HCMV DNA检测对于诊断婴儿HCMV感染和治疗监测具有重要的价值。肝功能的检测对判断HCMV感染严重程度有一定的参考价值。
목적：응용실시형광정량취합매련반응（ FQ-PCR）검측의사인거세포병독（ HCMV）감염적환인뇨액、혈액급대응모친유즙중HCMV DNA함량，탐토기재HCMV감염진단중적개치급대간장손상정황。방법응용FQ-PCR방법검측104례의사HCMV감염환인신선뇨액상피세포、혈액급기대응적모친유즙중적HCMV DNA고패수，병동시검측환인혈액중천동안산전안매（ AST）、병안산전안매（ ALT）、곡안선전태매（GGT）、총담홍소수평。결과뇨액、혈액표본양성검출솔분별위52．9％（55/104），24．0％（25/104），뇨액양성솔명현고우혈액양성솔，이자차이유통계학의의（P＜0．01）。유즙표본양성검출솔위81．7％（85/104），대응환인혈액화/혹뇨액양성솔위62．4％（53/85），이자차이유통계학의의（P＜0．05）。차환인HCMV고패수월고，간장손상적가능성월대。결론영인뇨액중HCMV DNA검측솔명현고우혈액적검출솔，차고패수월고，간공능손상적가능성취월대。뇨액HCMV DNA검측대우진단영인HCMV감염화치료감측구유중요적개치。간공능적검측대판단HCMV감염엄중정도유일정적삼고개치。
Objective To investigate the diagnostic value of fluorescent quantitative polymerase chain re-action ( FQ-PCR) technique in detecting the human cytomegalovirus infection and its impact on hepatic function through the detection of human cytomegalovirus (HCMV) DNA in urinary epithelial cell (EC), blood of breast-feeding infants and the milk of their mothers .Methods FQ-PCR was used to analyze the HCMV DNA in urinary EC, blood of 104 breast-fed suspected infants and breast milk of their mothers .The hepatic impairment was ana-lyzed through detecting aspartate aminotransferase ( AST ) , alanine aminotransferase ( ALT ) , gamma glutamyl transpeptidase ( GGT ) and total bilirubin .Results The positive rate of urinary EC and blood was 52.9%(55/104) and 24.0% (25/104) respectively.The positive rate of urinary EC was much higher than that of blood.The differences between these groups were statistically significant (P<0.01).The positive rate of breast milk was 81.7%(85/104), and the positive rate of the paired urinary EC and/or blood in positive breast milk test was 62.4%(53/85).The difference between the two groups was statistically significant (P<0.05).The possibility of hepatic impairment was much higher with the HCMV DNA copies in infants .Conclusions Detection of HCMV DNA load in urinary EC by FQ-PCR can predict HCMV active infection in infants and monitor the treat-ment of HCMV infection .The level of AST , ALT, GGT and total bilirubin can be used for evaluating hepatic im-pairment .