CAJ | 학술논문

目的探讨器宫移植术后应用核酸基础序列扩增法(NASBA)检测即刻早期抗原(IE)-mRNA对人外周血中巨细胞病毒(HCMV)感染的诊断价值,以评价和推广CMV活动性感染的诊断方法.方法肾移植术后患者32例,分别于术后3、7周采血5～7ml,每次同时进行针对CMV感染的NASBA、实时荧光定量PCR(Real time-PCR)、ELISA法检测.比较三者的敏感度和特异度.结果 32例肾移植术后受体CMV检测结果显示,采用NASBA法外周血IE-mRNA阳性率为45.8％ (15/32)；Real time-PCR法检测HCMV-DNA阳性率45.8％ (15/32)；ELISA法检测HCMV-(IgG+ IgM)阳性率37.5％(14/32).IE-mRNA、HCMV-DNA灵敏度和特异度明显优于HCMV-(IgG+ IgM),且可以降低后者存在的假阳性率.有CMV症状者共14例,其中NASBA法IE-mRNA检测阳性患者占92.8％ (13/14)；Real time PCR、ELISA 法阳性率分别为71.5％ (10/14)和42.8％ (6/14).结论 NASBA和Real time-PCR是一种敏感、快速诊断HCMV感染的方法,灵敏度及特异性均高于传统ELISA法,并能弥补ELISA的假阴性.NASBA检测IE-mRNA对于辅助临床诊断具有很好的价值.
목적 탐토기궁이식술후응용핵산기출서렬확증법(NASBA)검측즉각조기항원(IE)-mRNA대인외주혈중거세포병독(HCMV)감염적진단개치,이평개화추엄CMV활동성감염적진단방법.방법 신이식술후환자32례,분별우술후3、7주채혈5～7ml,매차동시진행침대CMV감염적NASBA、실시형광정량PCR(Real time-PCR)、ELISA법검측.비교삼자적민감도화특이도.결과 32례신이식술후수체CMV검측결과현시,채용NASBA법외주혈IE-mRNA양성솔위45.8％ (15/32)；Real time-PCR법검측HCMV-DNA양성솔45.8％ (15/32)；ELISA법검측HCMV-(IgG+ IgM)양성솔37.5％(14/32).IE-mRNA、HCMV-DNA령민도화특이도명현우우HCMV-(IgG+ IgM),차가이강저후자존재적가양성솔.유CMV증상자공14례,기중NASBA법IE-mRNA검측양성환자점92.8％ (13/14)；Real time PCR、ELISA 법양성솔분별위71.5％ (10/14)화42.8％ (6/14).결론 NASBA화Real time-PCR시일충민감、쾌속진단HCMV감염적방법,령민도급특이성균고우전통ELISA법,병능미보ELISA적가음성.NASBA검측IE-mRNA대우보조림상진단구유흔호적개치.
Objective To investigate the diagnostic value of the immediate early antigen(IE) mRNA by nucleic acid sequence-based amplification(NASBA) in peripheral blood cytomegalovirus (CMV) infection,and to establish and promote the diagnosis method for CMV.Methods Five to seven ml blood was taken from 32 patients at 3 week and 7 week after renal transplantation to detect serum cytomegalovirus antigen and antibody expression by NASBA,Real time-PCR and enzyme-linked immunosorbent assay (ELISA) sensitivity and specificity were compared.Results The results of CMV detection in 32 renal transplanted patients respectively showed that the positive rate of peripheral blood IE-mRNA by NASBA was 45.8％ (15/32) ;The positive rate of HCMV-DNA in blood by Real time-PCR was 45.8％ (15/32).Using ELISA,the positive rate of HCMV-(IgG +IgM) was 37.5％ (14/32).IE-mRNA and HCMV-DNA had higher sensitivity and specificity and lower false positive rate than HCMV-(IgG +IgM).The positive rates of IE-mRNA by NASBA,Real time-PCR and ELISA were 92.8％,71.5％ and 42.8％ respectively in the 14 cases.Conclusion The nucleic acid amplification method (NASBA based sequence) and Real time-PCR are sensitive,rapid diagnosis methods of HCMV infection,with higher sensitivity and specificity and lower false positive rate than traditional ELISA.And NASBA detection of IE-mRNA has good value for auxiliary clinical diagnosis.