荧光定量PCR与PP65抗原检测在诊断儿童巨细胞病毒活动性感染的比较

目的用实时荧光定量聚合酶链反应(FQ-PCR)和pp65抗原检测儿童人巨细胞病毒(HCMV)感染,并对其诊断HCMV活动性感染进行比较评估。方法分析924例HCMV血清学检测阳性的儿童的全血HCMV-DNA荧光定量PCR及HCMV-pp65抗原检测结果,与临床诊断的符合程度进行比较。结果全血HCMV-DNA荧光定量PCR和pp65抗原检测的一致率为81.17%,其标准误为0.39,Kappa值为0.60;PCR检测HCMV感染的灵敏度为98.4%,特异度为97.3%,Youden指数为0.957,PVP和PVN分别为0.961和0.989;pp65抗原检测用于检测HC-MV感染的灵敏度为59.2%,特异度为100%,Youden指数为0.592,PVP和PVN分别为1.00和0.782。结论全血HCMV-DNA荧光定量PCR和pp65抗原检测的结果有较好的一致性,诊断HCMV感染PCR检测的灵敏度较pp65抗原检测的灵敏度要高,而后者的特异度较前者高。二种方法都可用于CMV活动性感染的诊断。

Comparison of the performances of fluorescence quantitative PCR and PP65 antigenemia assay in detection of active HCMV infection in children

Objective To compare the performances of real-time fluorescence quantitative polymerase chain reaction（PCR） and pp65 antigenemia assay in diagnosis of human cytomegalovirus（HCMV） infection.Methods Comparing the results of whole blood HCMV-DNA PCR and HCMV-pp65 antigenemia assay for 924 children whose HCMV serological test is positive,and analyzing the coincidence degree of the test results with the clinical diagnosis.Results The consistent rate of whole blood HCMV-DNA PCR test and pp65 antigenemia assay was 81.17%,standard error was 0.39,value of Kappa was 0.60;the sensitivity of PCR test for detection of HCMV infection was 98.4%,the specificity was 97.3%,Youden index was 0.957,PVP and PVN were 0.961 and 0.989,respectively;the sensitivity of pp65 antigenemia assay for detection of HCMV infection was 59.2%,the specificity was 100%,Youden index was 0.592,PVP and PVN were 1.00 and 0.782,respectively.Conclusion Good agreement（κ=0.6） was found between HCMV-DNA PCR test and pp65 antigenemia assay.The sensitivity of real-time fluorescence quantitative PCR in detection of HCMV infection was much higher than that of pp65 antigenemia assay,while the specificity of the latter was higher than the former.Both of the two methods can be used for the diagnosis of HCMV active infection.