原位聚合酶链反应技术检测结节性红斑皮损中Ⅱ型单纯疱疹...

目的 探讨结节性红斑（ＥＮ）的发病与Ⅱ型单纯疱疹病毒（ＨＳＶ－２）的关系。方法 用原位聚合酶链反应法（ＩＳＰＣＲ）,对３５ＮＥ皮损组织及１４例正常皮肤组织切片中的ＨＳＶ－２ＤＮＡ进行扩增,ＳＰ免疫组化染色,ＡＥＣ显色,结果 ＨＳＶ－２ＤＮＡ在ＥＮ及正常皮肤中的检出率分别为５７．１％（２０／３５）、８．３％（２／１４）,Ｐ〈０．０１,阳性信号主要位于皮损部位,以小血管为著,细胞内的分布以核内型为主,     

STD门诊患者血清HSV－2 IgG抗体检测报告

采用ＥＬＩＳＡ技术检测了８０例ＳＴＤ门诊患者（其中淋病１４例、非特异性泌尿生殖道感染３８例及尖锐湿疣２８例）血清单纯疱疹病毒２型（ＨＳＶ－２）ＩｇＧ抗体。结果发现ＳＴＤ患者血清ＨＳＶ－２ＩｇＧ抗体阳性率为６０．０％，远比正常人群中的２５．３％为高（Ｐ＜０．００１），说明生殖器疱疹病毒感染在我国与西方国家一样，有上升和流行趋势。     

药物反应

２００００９４６ １４２例药疹病人临床分析／池信银（福州市皮肤病医院）…／／福建医药杂志．－１９９９，２１（２）．－７２～７３ 致敏药物共３４种。其中抗生素占首位，共９８例（６９％），解热镇痛２８例（９．７％），镇静安眠药３例（２．１％），其它８例（５．６％）。其中荨麻疹型７２例（５０．７％），多形红斑型３０例（２１．１％），固定红斑型１９例（１３．４％），麻疹样型１３例（９．２％），大疱表皮松解型３例（２．１％），红皮病样型和重症多形红斑型各２例（各占１．４％），猩红热样型１例（０．９％）。男女…     

STD门诊患者血清HSV—2IgG抗体检测报告

采用ＥＬＩＳＡ技术检测了８０例ＳＴＤ门诊患者（其中淋病１４例、非特异性泌尿生殖道感染３８例及尖锐湿疣２８例）血清单纯疱疹病毒２型）ＨＳＶ－２）ＩｇＧ抗体。结果发现ＳＴＤ患者血清ＨＳＶ－２ＩｇＧ抗体阳性率为６０．０％，远比正常人群中的２５．３％为高（Ｐ＜０．００１），说明生死器疱疹病毒感染在我国与西方国家一样，有上和流行趋势。     

原位聚合酶链反应技术检测结节性红斑皮损中Ⅱ型单纯疱疹病毒DNA

目的　探讨结节性红斑（ Ｅ Ｎ） 的发病与Ⅱ型单纯疱疹病毒（ Ｈ Ｓ Ｖ２） 的关系。方法　用原位聚合酶链反应法（ Ｉ Ｓ Ｐ Ｃ Ｒ） ,对３５ 例 Ｅ Ｎ 皮损组织及１４ 例正常皮肤组织切片中的 Ｈ Ｓ Ｖ２ Ｄ Ｎ Ａ 进行扩增, Ｓ Ｐ 免疫组化染色, Ａ Ｅ Ｃ 显色。结果　 Ｈ Ｓ Ｖ２ Ｄ Ｎ Ａ 在 Ｅ Ｎ 及正常皮肤中的检出率分别为５７ ．１ ％ （２０／３５） 、８ ．３ ％ （２／１４） , Ｐ＜ ０ ．０１ ,阳性信号主要位于皮损部位,以小血管为著,细胞内的分布以核内型为主,亦有核浆混合型。结论　 Ｅ Ｎ 的发病与 Ｈ Ｓ Ｖ２ 有关。     

性乱人群中2型单纯疱疹病毒感染的分析

目的 为了解性乱人群不典型皮损中及无皮损的生殖道分泌物中２型单纯疱疹病毒（ＨＳＶ２）的感染情况。方法 在ＨＳＶ２高度保守的基因区设计一对引物，利用聚合酶链反应，对合肥地区６２０例性乱者作ＨＳＶ２－ＤＮＡ检测。结果 ３７５例不典型皮损的恬乱人群中，１４１例检出ＨＳＶ２－ＤＮＡ，阳性率为３７．６％，其中男性占３３．６％，女性占４７．７％。     

生殖器疱疹的诊断及感染特征探讨

细胞培养法对８０例临床诊断为典型生殖器疱疹的患者进行了人类单纯疱疹病毒（ＨＳＶ）分离，并结合链霉亲和素过氧化物酶免疫组化法（ＬＳＡＢ）及ＰＣＲ法对其中部分患者进行了ＨＳＶ及其型别检查。三种方法的ＨＳＶ检出率分别为５８．８％、２０％、９０％；培养法作为金标准特异性高，对早期患者检出率达８６．４％；ＰＣＲ法与其他两法比较敏感性高，并利于ＨＳＶ型别的诊断；ＬＳＡＢ法对临床标本的检出率虽很低，却可提高培养法的检出率。ＨＳＶ的感染型别ＨＳＶ２占９１．７％、ＨＳＶ１占８．３％。还讨论了ＰＣＲ引物的优点，并总结了本组患者的临床感染特征。     

聚合酶链反应检测多形红斑皮损中单纯疱疹病毒DNA

为了研究多形红斑（ＥＭ）与单纯疱疹病毒（ＨＳＶ）之间的关系，特别是探讨与疱疹相关的ＥＭ的临床特点及其在ＥＭ发病中所占比例，应用聚合酶链反应（ＰＣＲ）方法检测了６０例ＥＭ的典型皮损的活检组织和３２例正常组织及疾病对照标本中的ＨＳＶＤＮＡ。结果显示：２１例（３５％）ＥＭ患者检测出ＨＳＶ特异ＤＮＡ，对照标本（１６份正常皮肤组织和１６份其它皮肤病的皮损标本）中未发现ＨＳＶＤＮＡ。根据病史提供，６０例ＥＭ中有５例是药物相关的ＥＭ，８例是病毒相关的ＥＭ，其余４７例为特发型ＥＭ。研究表明：２１例ＰＣＲＨＳＶＤＮＡ阳性的ＥＭ患者中，仅有２例发病前有口唇疱疹病史，１５／２１例（７１．４％）是复发性ＥＭ，发病高峰在冬季。尽管临床上无明显ＨＳＶ感染史，多数特发性ＥＭ也与疱疹病毒感染有关。ＰＣＲ技术是检测ＥＭ皮损中ＨＳＶ的快速、有效的方法，它可以决定病因上和ＨＳＶ感染有关的病例。     

性病门诊患者人类免疫缺陷病毒和单纯疱疹病毒感染的血清学检测

为了解我同性病患者中人类免疫缺陷病毒（ＨＩＶ）和单纯疱疾病毒（ＨＳＶ）感染的流行情况，我们选择了我所性病门诊的病人进行了淋球菌分离培养以及ＨＩＶ和ＨＳＶ感染的血清学检测。结果表明，８８份临床标本淋球菌分离培养阳性率为２８．４％。ＨＳＶ－１和ＨＳＶ－２抗体检出率分别为５９．１％和２５．０％。统计分析结果表明，淋球菌感染和ＨＳＶ－２抗体阳性之间有一定的相关性（Ｐ＜０．０１）。８８份血清标本ＨＩＶ抗体检出率为０．     

性病门诊患者人类免疫缺陷病毒和单纯疱疹病毒感染的血清学检测

为了解我同性病患者中人类免疫缺陷病毒（ＨＩＶ）和单纯疱疾病毒（ＨＳＶ）感染的流行情况，我们选择了我所性病门诊的病人进行了淋球菌分离培养以及ＨＩＶ和ＨＳＶ感染的血清学检测。结果表明，８８份临床标本淋球菌分离培养阳性率为２８．４％。ＨＳＶ－１和ＨＳＶ－２抗体检出率分别为５９．１％和２５．０％。统计分析结果表明，淋球菌感染和ＨＳＶ－２抗体阳性之间有一定的相关性（Ｐ＜０．０１）。８８份血清标本ＨＩＶ抗体检出率为０．     

Herpes simplex virus antigens and inflammatory cells in oral lesions in recurrent erythema multiforme. Immunoperoxidase and autoradiographic studies

Herpes simplex virus (HSV) antigens were sought in 15 biopsy specimens from both lesional mucosa and clinically healthy looking oral mucosa between attacks in patients with erythema multiforme (EM). Four of the eight biopsy specimens obtained from lesional EM mucosa stained positively with HSV-1-and/or HSV-2-specific antisera applied in direct immunoperoxidase staining. Of the 16 tissue specimens used as controls, two displayed positive staining with HSV-1 and/or HSV-2. Five of the seven biopsy specimens from macroscopically healthy oral mucosa obtained between attacks from patients with recurrent EM stained positively with HSV-1 and/or HSV-2. Of the six tissue specimens used as controls, three stained positively. Most of the local inflammatory mononuclear cells belonged to the T cell series, mainly to the CD-4 subset. A small proportion of the local T cells were blast transformed as assessed by CD-25 expression and [3H]thymidine incorporation. This, together with the findings showing a lower degree of activation in the biopsy from macroscopically healthy looking mucosa between attacks suggest an active role of the cell-mediated immune response in the genesis of oral lesions in EM. The persistence of HSV antigens, and the well-established role of HSV as a precipitating factor in recurrent EM, suggest that HSV may be involved, but since HSV seems to be present in other mucosal lesions as well as in clinically healthy mucosa, quite frequently an additional, hitherto unknown factor must be present in order that EM may occur.     

对ELISA检测生殖器疱疹患者HSV及其临床应用的评价

目的评价酶联免疫吸附试验(ELISA)检测生殖器疱疹病毒的临床应用价值。方法采用ELISA和分型聚合酶链反应(分型PCR)检测生殖器标本中的单纯疱疹病毒(HSV),两种试验结果不符合者采用不分型PCR检测。结果164例受检者中,ELISA法HSV阳性96例(58.5%),其中具典型皮损者阳性84例(80.8%,84/104),非典型皮损阳性12例(20.0%,12/60);分型PCRHSV阳性98例(59.8%),其中典型皮损者HSV阳性86例(82.7%,86/104),非典型皮损者阳性12例(20.0%,12/60)。HSV1感染者占生殖器疱疹的5.1%,HSV2感染占88.7%,HSV1和HSV2混合感染者占6.1%。ELISA的敏感性和特异性分别为96.7%和94.0%。结论ELISA检测HSV感染,其敏感性高、特异性强,方便、快速,尤其适合大批量样本的检测。     

女性原发性生殖器疱疹中HSV-Ⅱ的检测及意义

目的探讨单纯疱疹病毒Ⅱ型(HSV-Ⅱ)与女性原发性生殖器疱疹(GH)的相关性及意义。方法应用酶联免疫吸附法(ELISA)分别检测患者血清中HSV-Ⅱ抗体以及分泌物中的HSV-Ⅱ抗原。结果HSV-Ⅱ中IgG均阴性的138例女性生殖器疱疹患者中HSV-Ⅱ抗原阳性78例(56.52%);HSV-Ⅱ中IgM抗体阳性130例(94.20%),抗体阳性率明显高于抗原阳性率(P<0.01)。典型病例组抗原阳性65例(87.84%),IgM抗体阳性66例(89.19%);不典型病例组抗原阳性13例(20.31%),IgM抗体阳性64例(100.00%)。结论对于皮损时间短,症状典型者可检测HSV-Ⅱ抗原;皮损时间长,或反复者可检测HSV-Ⅱ抗体,可以有效提高HSV感染的临床诊断率。     

Detection of HSV-specific DNA in biopsy tissue of patients with erythema multiforme by polymerase chain reaction

Formalin-fixed paraffin-embedded skin biopsies of lesions of erythema multiforme (EM) from 32 patients and 13 controls were examined for the presence of herpes simplex virus (HSV) by polymerase chain reaction (PCR) and for histological findings by direct immunofluorescence and staining with haematoxylin and eosin. HSV-specific DNA was detected in 23 (72%) patients. A history of recurrent skin rash was present in 59% of the PCR-positive cases, while 55% had had suspected HSV infections. Only two PCR-positive specimens were found in patients without a history of recurrent rash and/or previous oral lesions. One biopsy was positive for HSV by conventional cell cultures. There was no significant difference in histology between HSV-related and HSV-negative cases of EM. In the 13 control specimens [bullous pemphigoid (3), dermatitis herpetiformis (2), lichen planus (1), aphthous ulcer (1), fixed-drug eruption (1), varicella-zoster (1), hypereosinophilic syndrome (1), photocontact dermatitis (1), contact dermatitis (1), and cellulitis (1)], no HSV-DNA was detected.     

抗原捕获聚合酶链反应分型检测妇女生殖器单纯疱疹病毒

目的 :　建立直接分型检测妇女生殖器单纯疱疹病毒 (HSV)的抗原捕获聚合酶链反应 (AC -PCR)。方法 :　用抗HSV型共同性糖蛋白单克隆抗体 ,包被聚苯乙烯离心管 ,捕获HSV ,同时加入 3个引物 :HSV - 1 HSV - 2型共同性上游引物及HSV - 1和HSV - 2型特异性下游引物 ,进行PCR扩增。结果 :HSV - 1和HSV - 2标准病毒株均分别扩增出与设计大小相符的 4 77bp和 399bpDNA条带。AC -PCR可检测到 10PFUHSV - 1和 1PFUHSV - 2。用AC -PCR检测了 36 5份妇女生殖器拭子标本 ,阳性 10 1例(2 7.7% ) ,2 3例为HSV - 1(占 2 2 .8% ) ,78例为HSV - 2 (占 77.2 % ) ;其中 112份标本同时用AC -PCR和分离培养法检测 ,AC -PCR的阳性率为 2 6 .8% (30 112 ) ,分离培养法的阳性率为 2 0 .5 % (2 3 112 ) ,两者差异有显著性 (χ2 =4 .5 ,P <0 .0 5 )。结论 :　AC -PCR是特异、敏感、快速分型检测妇女生殖器HSV感染的方法     

生殖器部位皮损的单纯疱疹病毒检测及分型

目的 探讨生殖器疱疹部位皮损的不典型表现及其与单纯疱疹病毒型别的关系。方法 对外生殖器部位及其周围有硬结或疖肿、裂隙、毛囊炎等非水疱性皮肤黏膜损害的患者进行临床资料采集和分析,并对皮损标本进行单纯疱疹病毒的分离培养、PCR检测和病毒分型。结果 105例有外生殖器部位非水疱性皮损的患者入选本研究,在硬结(或疖肿)、裂隙、毛囊炎、类似擦破、单个溃疡、非特异性红斑和红肿渗液性包皮龟头炎皮损中,PCR检测HSV的阳性率分别33.3%(6/18)、20%(3/15)、37.5%(6/16)、28.6%(2/7)、33.3%(4/12)、20%(5/25)和50%(6/12),总的检出阳性率为30.5%(32/105)。分离培养法检测HSV的阳性率分别为22.2%(4/18)、13.3%(2/15)、25%(4/16)、14.3%(1/7)、33.3%(4/12)、8%(2/25)和41.7%(5/12),总的检出阳性率为21%(22/105)。两种方法检测HSV的总检出率差异无统计学意义(κ=0.095,P=0.114)。HSV-PCR分型结果与荧光单克隆抗体分型结果相符。在所有HSV阳性者中,HSV-1感染占9.4%(3/32),HSV-2感染占90.6%(29/32)。结论 生殖器HSV感染的皮肤黏膜损害多样,可为外生殖器部位的硬结(疖肿)、裂隙、毛囊炎、类似擦破、单个溃疡、非特异性红斑和红肿渗液性包皮龟头炎等不典型表现,而且主要由HSV-2感染引起。     

宫颈糜烂患者单纯疱疹病毒Ⅱ型感染情况分析

目的探讨宫颈糜烂患者单纯疱疹病毒(HSV-Ⅱ)感染情况。方法用实时荧光定量PCR法对212例受试者宫颈棉拭子中HSV-Ⅱ进行检测。结果 162例宫颈糜烂患者中,HSV-Ⅱ阳性率为29.01%(47/162),50例正常对照组中,HSV-Ⅱ阳性率为10.00%(5/50),两组差异有统计学意义(P<0.05)。Ⅰ,Ⅱ和Ⅲ度宫颈糜烂患者HSV-Ⅱ阳性率分别为19.64%(11/56),27.78%(15/54)和40.38%(21/52),提示宫颈糜烂程度与HSV-Ⅱ的阳性率呈正相关(r=0.186,P<0.05)。结论 HSV-Ⅱ感染与宫颈糜烂密切相关,且随宫颈糜烂程度的增加,HSV-Ⅱ感染率增加。应加强对宫颈糜烂患者HSV-Ⅱ的检测。     

High seroprevalence of HSV-1 and HSV-2 in STD clinic attendees and non-high risk controls: a case control study at a referral hospital in south India

BACKGROUND: In Asia, HSV seroprevalence studies are sparse and they have recorded lower prevalence of HSV infection, especially HSV-2. AIMS: To ascertain the seroprevalence of HSV-1 and HSV-2 in patients attending a STD clinic in a referral hospital in south India and to compare it with a control group. METHODS: The study included 135 consecutive STD cases having history of ulcerative or non-ulcerative STD in the present or in the past 5 years and 135 age and sex-matched controls. Diagnostic serology was done for HSV-1 and HSV-2 using type specific IgG by indirect immunoassay using ELISA. The results were analyzed utilizing Chi- square test. RESULTS: Amongst 135 STD clinic cases, 106 cases were males and 29 cases were females with male to female ratio of 3.65:1. The mean age was 32.2 years (range 16-65 years). Among study group cases, 112 (82.9%) cases were co-infected with HSV-1 and HSV-2, 11 (8.1%) cases were seropositive for HSV-1 alone and 3 (2.2%) cases were seropositive for HSV-2 alone. In the control group, 112 (82.9%) cases were co-infected with HSV-1 and 2, 12 (9.6%) for HSV-1 alone and 1(0.8%) for HSV-2 alone. Correlation of HSV-1 and HSV-2 serology with various demographic and behavioral factors was statistically insignificant. CONCLUSIONS: Seroprevalence of HSV-1 and HSV-2 in STD clinic cases and control group is high, similar to that recorded in sub-Saharan Africa. Thus, serological studies for HSV-1 and HSV-2 cannot be taken as a marker of sexual behavior in our set of population.     

彩色乳胶免疫层析法检测单纯疱疹病毒1,2型抗原临床应用分析

目的探讨彩色乳胶免疫层析法检测单纯疱疹病毒(HSV)1和2型抗原的临床应用价值。方法采用彩色乳胶颗粒免疫层析法检测各种水疱、溃疡和其他皮损中的HSV-1和2型抗原,同时用实时荧光定量PCR法进行对照。结果免疫层析法可检出≥1×106DNA拷贝/mL的HSV-1型混悬液和≥5×105DNA拷贝/mL的HSV-2型混悬液。132例标本中,免疫层析法检出HSV阳性43例,PCR检出HSV阳性50例。以PCR法为金标准,免疫层析法的灵敏度、特异度、阳性预测值和阴性预测值分别为84.00%,98.78%,97.67%和91.01%。结论免疫层析法检测HSV敏感性和特异性高,具有方便、快速和经济的特点,适于有症状患者的及时检测,对疱疹感染早期诊断和及时治疗有重要作用。     

Detection of herpes simplex virus DNA in cutaneous lesions of erythema multiforme

The association between erythema multiforme (EM) and herpes simplex virus (HSV) infection has long been appreciated, although the exact role which HSV may play in the pathogenesis of this herpes-associated EM (HAEM), is unknown. Previous studies have suggested, but not definitively demonstrated, the presence of HSV in lesions of HAEM. The presence of HSV would support the hypothesis that an immune-mediated response directed against HSV-specific antigens in the skin is central to lesion development in HAEM. The purpose of this study was to examine lesions of EM for the presence of HSV DNA by using the polymerase chain reaction (PCR). In addition, in situ hybridization using an HSV-specific RNA probe was performed to further localize the HSV nucleic acids within the skin. DNA was extracted from formalin-fixed, paraffin-embedded specimens of cutaneous lesions of HAEM and also from EM for which no precipitating factor could be documented, otherwise known as idiopathic EM (IPEM). DNA from lesions of bullous pemphigoid served as a negative control. Using PCR to specifically amplify HSV sequences which might be present, and then performing Southern analysis, we demonstrated HSV DNA in 9/13 HAEM and 6/9 IPEM biopsies. No HSV was detected in six lesions of bullous pemphigoid. In situ hybridization of three cutaneous HAEM lesions using an 35S-labeled HSV-specific RNA probe localized the HSV nucleic acids predominantly to the epidermis. Three biopsies of chronic dermatitis, used as negative controls, did not demonstrate this specific hybridization. These findings confirm the presence of HSV in lesions of HAEM and are consistent with the concept of an HSV-specific immune-mediated pathogenesis for this disease. In addition, most cases of IPEM appear to be herpes associated despite the absence of clinically apparent HSV infection.