尿巨细胞病毒-DNA载量与血清巨细胞病毒-IgM检测在新生儿巨细胞感染中的价值

目的 以实时荧光定量PCR法（FQ-PCR）检测尿液中巨细胞病毒载量,以化学发光法检测血清中CMV-IgM,探讨两种方法 联合应用在新生儿巨细胞病毒（CMV）感染中的临床价值.方法 144例疑似CMV感染新生儿的血清用化学发光检测CMV-IgM,尿液用FQ-PCR检测CMV-DNA载量,比较抗病毒治疗前、后两种检测结果 的变化.结果 两种方法 单独检测的阳性率分别为55.56%和66.67%,两者比较,差异无统计学意义（χ2=3.20,P＞0.05）,两种方法 联合检测的阳性符合率为76.39%（110/144）,明显高于两方法 单独检测阳性率,差异均有统计学意义（χ2分别=4.47、5.21,P均＜0.05）.抗病毒治疗后血CMV-IgM和尿CMV-DNA两种检测结果 均较治疗前明显下降,差异均有统计学意义（t分别=7.45、9.31,P均＜0.05）.结论 尿液CMV-DNA病毒载量与化学发光法血清CMV-IgM联合检测,可以明显提高新生儿巨细胞病毒感染检测的阳性率.

Clinical value of the detection of CMV viral load in urine and CMV-IgM in serum for the newborns with the human cytomegalovirus infection

Objective To detect CMV viral load in the urine and CMV-IgM in the serum and to study the clinical value of the combined detection for the newborns with human cytomegalovirus infection. Methods In 144 newborns of doubtful CMV infection, CMV-IgM in the serum was detected by the chemiluminescence method and CMV-DNA viral load in the urine was detected by FQ-PCR, and compared between pretherapy and post-treatment which used anti-virus drugs. Results The positive rate of two methods were 55.56% and 66.67% respectively,the significance and the difference between two methods was not obviously （χ2=3.20,P〉0.05）.The positive rate of combined detection by two methods was 76.39% （110/144）, which was higher obviously than that of the single （χ2=4.47, 5.21, P〈0.05 ）. There was significantly decrease compared the post-treatment with pretherapy in the copies of CMV-DNA in urine and the index of CMV-IgM（t= 7.45,9.31 ,P 〈0.05）. Conclusions The combined application of CMV-IgM in the serum using chemiluminescence method and the copies of CMV-DNA in urine using FQ-PCR would obviously raise the positive rate of detection for the newborns with the human cytomegalovirus infection.