摘要
目的 :采用酶联免疫吸附法 (ELISA)、定性及定量聚合酶链反应法 (PCR)监测肾移植术后巨细胞病毒(Cytomegalovirus,CMV)活动性感染 ,探讨不同检测方法在肾移植术后CMV活动性感染防治中的价值。 方法 :于移植前、后抽取 1 0 8例肾移植受者的外周静脉血 ,采用ELISA法、定性及定量PCR法检测血液中CMV IgM及CMV DNA ;对于CMV活动性感染者应用丙氧鸟苷治疗。 结果 :术后 58例患者发生CMV活动性感染。诊断CMV活动性感染的灵敏性和特异性 :ELISA法为 1 9%和 1 0 0 % ;定性PCR法为 71 %和 58% ;定量PCR法为 93 %和 1 0 0 %。在CMV活动性感染临床症状出现前 ,定性及定量PCR法检测CMV DNA的阳性率分别为 2 2 %和 86 % ,而ELISA法检测CMV IgM无一例阳性 ;用丙氧鸟苷治疗后 ,55例有效 ,3例无效。 结论 :与ELISA法及定性PCR法比较 ,定量PCR法能够更灵敏、特异的监测肾移植术后CMV活动性感染 ,并可用于评价丙氧鸟苷的抗病毒疗效 。
Objective:To evaluate the specificity and sensitivity of different assays in detection and monitoring of CMV infection in renal allograft recipients. Methodology:Serum and whole blood samples from 108 consecutive renal allograft recipients were collected for early diagnosis and monitoring of CMV infection.Of the 108 recipients,58 were confirmed to be infected with CMV by clinical investigation and laboratory studies including the detection of serum CMV IgM antibodies and/or CMV DNA.ELISA kit was applied in the detection of CMV IgM antibodies.Both qualitative and quantitative PCR were used for the detection of CMV DNA.Series of samples from CMV infected recipients,either symptomatic or asymptomatic,were collected for the monitoring the efficacy of ganciclovir treatment. Results:The sensitivity and specificity of ELISA,qualitative PCR and quantitative PCR for symptomatic CMV infection were 19% and 100%,71% and 58%,93% and 100% respectively.In the monitoring of the 108 recipients for CMV infection,qualitative PCR was found to turn positive in 13 and quantitative PCR to turn positive in 50 before the appearance of CMV infection associated symptoms,accounting for 22% and 86% of the CMV infected recipients respectively.While ELISA detected CMV IgM was negative in 55 of the 58 CMV infected recipients before the appearance of CMV infection associated symptoms,with 11 turned positive after the appearance of the symptoms.Ganciclovir treatment was effective in 55 of the 58 CMV infected recipients. Conclusion:For early detection of CMV infection in renal allograft recipients,quantitative PCR is the most sensitive and specific assay.ELISA is the lest sensitive although specific for the confirmation of the diagnosis.Besides,quantitative PCR is of value in evaluating viral load and in monitoring antiviral efficacy.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
2002年第2期120-123,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
肾移植
巨细胞病毒
检测
renal transplantation cytomegalvirus detection
