荧光定量PCR和外周血白细胞pp65抗原血症实验对肾移植术后巨细胞病毒感染的检测

目的 探讨肾移植术后3个月巨细胞病毒(CMV)的感染状况，比较荧光定量PCR和外周血白细胞pp65抗原血症实验两种方法对肾移植术后巨细胞病毒感染的检测情况和使用价值。方法 分别用荧光定量PCR、外周血白细胞pp65抗原血症实验和ELISA法对我院2001年1月～2002年12月56例肾移植患肾移植术后3个月的外周血进行巨细胞病毒的检测。结果 56例肾移植患中CMVpp56抗原血症阳性9例(16．1％)，PCR阳性11例(19．6％)，12例(21．4％)诊断为CMV感染，其中7例为症状性感染，5例为无症状性感染。荧光定量PCR和外周血白细胞pp65抗原血症实验的一致性为92％，阳性符合率67％，阴性符合率92％。CMVpp65抗原、CMV DNA PCR、CMV—IgM的敏感性、特异性分别为72％、92％；100％、92％；43％、88％。结论 荧光定量PCR和外周血白细胞pp65抗原血症实验的联合应用，对监测CMV活动性感染、临床疗效及预后更加客观、准确。

Comparision of fluorescent quantitative polymerase chain reaction and pp65 antigenemia assay for detection of human cytomegalovirus in renal transplant patients

Objective To compare the results obtained using fluorescent quantitative polymerase chain reaction and pp65 antigenemia assay on the samples collected from recipients at three months after kidney transplantation and to observe the state of cytomegalovirus infection.Methods 56 samples from 56 patients at 3 months after kidney transplantation were tested for cytomegalovirus by pp65 antigenemia assay,and fluorescent quantitative polymerase chain reaction and ELISA.Results 16 1% of the patients are positive to pp65 antigen and 19 6% are positive to polymerase chain reaction.Of the 56 patients,12 developed cytomegalovirus infection,seven of whom were symptomatic.The concordance between PCR and pp65 antigenemia assay was 92%.The positive concordance was 67%.The negative concordance was 92%.The sensitivity and specificity of the pp65 antigenemia assay PCR and ELISA were 72%,92%;100%,92%;43%,88% respectively.Conclusion It is more accurate and objective to use fluorescent quantitative polymerase chain reaction and pp65 antigenemia assay together to monitor active cytomegalovirus infection and the effect of the treatment.