造血干细胞移植后对人巨细胞病毒感染病毒载量的检测

目的探讨应用实时定量聚合酶链反应（RQ-PCR）法对异基因造血干细胞移植（allo—HSCT）后巨细胞病毒（CMV）感染的诊断价值及对临床用药的指导意义。方法33例行allo-HSCT的患者于造血重建后，应用RQ-PCR法对其外周血CMV DNA进行动态检测，根据检测结果决定抗CMV治疗的开始、减量和终止，观察治疗效果和临床转归。结果共检出13例CMV感染患者，21次感染发作；除1次是患者中途放弃治疗外，余20次治疗中CMV DNA拷贝迅速转阴或下降至转阴，有临床表现者症状消失、器官功能恢复；且抗CMV疗程短于常规疗程。结论应用RQ—PCR法不但可以早期诊断CMV感染，及时干预治疗，还可以直观指导治疗的减量和终止、缩短疗程、减轻药物不良反应。

Application of real-time quantitative PCR for guidance therapy of cytomegalovirus infection after allo-hematopoietic stem cell transplantation

Objective To discuss the significance of the application of real-time quantitative PCR(RQ PCR)for diagnosis and guidance therapy of cytomegalovirus(CMV)infection after allo- hematopoietic stem cell transplantation(allo-HSCT).Methods Thirty-three patients were undergo- ing allo-HSCT.After hematopoietic reconstitution,patients'peripheral blood samples were detected for CMV DNA by RQ-PCR periodically.Anti-viral therapy was begun,attenuated and stopped ac- cording to the results of CMV DNA detection.The effects of anti-viral therapy and patients' clinical results were observed.Results CMV DNA was detected in blood samples from 13 of 33 patients. There were 21 episodes in these patients.Only 1 episode wasn't controlled hecause the patient gave up the therapy.CMV DNA copies were disappeared soon or decreased and then disappeared during anti-viral therapy in the others'.Patients which had symptoms and/or dysfunction of organs were cured too.Each course of anti-viral therapy was shorter than ordinary course.Conclusions CMV in- fection can he diagnosed as early as possible by RQ PCR.To begin,attenuate and stop anti-viral ther- apy according to the results of RQ-PCR is safe.The course is shortened and the side effects of anti vi- ral drugs were attenuated.