聚合酶链反应检测肾移植受者尿中人巨细胞病毒的临床应用

为探讨聚合酶链反应（ＰＣＲ）技术检测肾移植受者（ＲＴＲ）尿中人巨细胞病毒（ＨＣＭＶ）ＤＮＡ在临床工作中的应用及其价值，本组采用ＨＣＭＶ早期及晚期基因组两对引物及ＨＣＭＶ特异性单抗分别建立了ＰＣＲ技术及捕获、间接酶联法（ＭａｃＥＬＩＳＡ，ＩＥＬＩＳＡ）。应用ＰＣＲ检测ＲＴＲ尿中ＨＣＭＶＤＮＡ、ＭａｃＥＬＩＳＡ及ＩＥＬＩＳＡ法检测各受血者中ＨＣＭＶ－ＩｇＭ及ＩｇＧ，并比较其结果，表明：６５例ＲＴＲ尿中ＨＣＭＶＤＮＡ阳性率为６０％，ｌｇＭ及ＩｇＧ阳性者尿中ＨＣＭＶＤＮＡ阳性率各为８１．８％及５４．５％。说明ＰＣＲ应用存在一定局限性，应与血清学等方法相结合，取长补短，才能适应临床需要，充分发挥其应用价值。

GLINICAL APPLICATION OF DETECTION OF HUMAN CYTOMEGALOVIRUS IN URINE FROM RENAL TRANSPLANT RECIPIENTS USING POLYMERASE CHAIN REACTION

A polymerase chain reaction(PCR)assay that used two pairs of primers from the immediate early g n s and late genes of human HCMV AD169 strain was used to amplifyHCMV DNA directly from urine of renal transplant recipients. MacELISA and IELISAwere used to detect serum HCMV IgM and lgG of each recipient, while HCMV DNAwas detected by PCR,Of the 65 clinical urine samples, 39 were positive by PCR(60%).Of 33 IgM positive recipients,27 were positive by PCR(81.8%); of 55 IgGpositive recipients,30 were positive by PCR(54.5%).In recent and acute infection pa-tients,the frequency of PCR-positivity was higher than in latent ones(P< 0.01).Dete-ction of serial urine samples from patients whose first PCR result was negative, couldincrease the positive result.PCR technique for detecting HCMV DNA, although promisesa high sensitivity,and has the possibility of detecting latent HCMV infection, but onlyone time detection might lead to false-negative result.PCR in combination with serumHCMV antibody detection,multiple times detection and multiple primers amplifying dif-ferent areas of HCMV genome were necessary to avoid false-negative results. PCR amp-lification is a valuable tool for diagnosing HCMV infcction of rcnal transpiantationrecipients, in combination with MacELISA HCMV-IgM and IELISA HCMV-IgG dete-ction,it may give satisfactory clinical result.