造血干细胞移植后检出人类多瘤病毒尿的临床分析

 目的 研究造血干细胞移植后潜伏于体内的人类多瘤病毒（HuPV）-BK病毒（BKV）和JC病毒（JCV）的激活情况。方法 连续采集41例患者造血干细胞移植前后及10例正常对照的尿样本，用实时定量PCR检测病毒，半巢式PCR鉴定BKV和JCV病毒株。结果 造血干细胞移植后病毒尿阳性的患者共33例（80％），其中出现BKV尿者15人（45％）、JCV尿者3人（9％），在相同或不同时段尿样本中检出两株病毒者11人（33％），另外4人（12％）未能鉴定出病毒株；比较24例病人移植前、后病毒尿发生率，分别为19％、77％，存在显著性差异（P〈0．0001）；正常对照组没有检测到病毒（P〈0．0001）。结论 造血干细胞移植后HuPV病毒尿的发生率明显升高，但影响因素仍不明确，可能是多因素综合作用的结果，其临床意义还有待进一步探讨。

Clinical Analysis in Patients with Human Polyomaviruses Urine after Stem Cell Transplantation

Objective To study and profile human polyomavirus (HuPV) reactivation after hematopoietic stem cell transplantation (HSCT).Methods Continuously collected middlesteam urine samples from 41 patients with hematopoietic stem cells transplantation and 10 immunocompetent peoples as control group. HuPV DNA was detected with Real-Time PCR and the stains of BK virus and JC virus were distinguished with seminested PCR.Results 33 of the 41(80%) patients shed viruria after HSCT. Of them, 15 (45%) cases shed BK viruria, 3 (9%) cases for JCV and 11(33%) cases embraced two viral stains that simultaneously or separately in the urinary specimens. The viral stains were not identified in 4 (12%) cases. Comparison in 26 patients with the initial specimens prior to transplantation subjects that the incidence of viruria is significant increased after HSCT (P<0.0001) .Conclusion The amount of patients shedding HuPV in urine is significantly increased after HSCT. The impact factors remain ambiguous and the associated clinical significance should be further explored.