HCMVpp65抗原、HCMV mRNA和IgM抗体检测在诊断HCMV活动性感染中的比较

目的比较人巨细胞病毒（HCMV）pp65抗原、HCMV mRNA和血清HCMV—IgM抗体检测3种方法在诊断HCMV活动性感染中的实用意义。方法采集医院TORCH检查HCMV—IgM阳性的病人外周血（60份）。将标本分2份2ml和3ml，别用于HCMV mRNA和pp65检测。将三者结果进行比较。结果pp65抗原检测的结果与IgM抗体检测的阳性符合率为81．67％。与HCMV mRNA检测相比pp65抗原检测法的符合率、特异度和敏感度分别为81．67％，81．81％和81．63％。而且高pp65抗原血症与患者的临床症状密切相关。结论pp65抗原血症反映该病毒活动状况，可监测HCMV活动性感染，联合HCMV—IgM的检测可以提高临床的诊断率并可用于指导临床用药及监测药物疗效。

Comparison of the human cytomegalovirus pp65 antigen test , HCMV mRNA and the HCMV-specific IgM assay in the diagnosis of cytomegalovirus active infection

Objective： To compare the diagnostic efficacy of the human cytomegalovis （HCMV） pp65 antigen （abbreviated pp65 as followed） test, HCMV mRNA and the HCMV- specific IgM （abbreviated IgM as followed） assay in the diagnosis of active I-ICMV infection. Methods： Sixty blood samples obtained from the patient with HCMV IgM positive from out - patient clinic. Each sample is divided into two, 2 ml and 3 ml. The former was used for the HCMV mRNA assay and the latter was used for the pp65 antigen test. Results： The correspondence of the pp65 antigen test and the IgM assay was 81.67%. Compared with the HCMV mRNA by the RT - PCR , the correspondence, the specificity and the sensitivity of the pp65 antigen in the detection of the active HCMV infection were 81.67 %, 81.81% and 81.63 % respectively. Furthermore, the number of the pp65 antigen - positive cells detected by the pp65 antigen test was closely correlated with the clinical symptoms. Conclusions ： The pp65 antigen assay can reflect the level of HCMV and predict the active HCMV infection. The IgM assay can also be used as an assistant diagnostic tool for active cytomegalovirus infection, which is suggested to be applied in combination with pp65 antigen test. The pp65 antigen test also can be used to guide clinical treatment and monitoring of drug efficacy.