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人巨细胞病毒感染与系统性红斑狼疮的相关性
引用本文:陈静,章慧娣,楼威洋,邵蓉蓉,张丽芳,薛向阳,朱小春.人巨细胞病毒感染与系统性红斑狼疮的相关性[J].温州医学院学报,2014(5):318-323.
作者姓名:陈静  章慧娣  楼威洋  邵蓉蓉  张丽芳  薛向阳  朱小春
作者单位:[1]温州医科大学附属第一医院风湿免疫科,浙江温州325015 [2]温州医科大学附属第一医院肾内科,浙江温州325015 [3]温州医科大学第一临床医学院,浙江温州325035 [4]温州医科大学微生物学与免疫学教研室,浙江温州325035
基金项目:国家自然科学基金资助项目(81001343);浙江省自然科学基金资助项目(Y2100909,LY12H05003);浙江省科技厅科研基金资助项目(2012C33126,2010C33094)。
摘    要:目的:分析人巨细胞病毒(HCMV)在系统性红斑狼疮(SLE)患者中的感染状况及与SLE临床指标的相关性。方法:采集并分离60例SLE患者和111例健康体检者的外周血白细胞及血清标本,建立细胞内HCMVUL55及UL138基因高度敏感特异的PCR方法,并检测SLE患者及健康体检者外周血白细胞内HCMVUL55及UL138基因,以确定HCMV感染情况,利用罗氏公司电化学发光法试剂盒检测血清HCMVIgG和IgM,比较SLE患者与健康体检者外周血白细胞内HCMVUL55、UL138检测及血清IgG、IgM检测的阳性率和相关性,统计分析外周血白细胞内HCMV感染与SLE常见临床指标的关系。结果:琼脂糖凝胶电泳及测序结果显示,建立的PCR方法能特异地检测外周血白细胞内HCMVUL55及UL138基因;血清HCMVIgG及细胞内HCMVUL138基因检测几乎全部呈阳性,SLE患者与健康体检者之间差异无统计学意义(P>0.05);血清HCMVIgM检测阳性率低,SLE患者血清HCMVIgM检测阳性率(为6.67%)略高于健康体检者(为0.90%)(P=0.052);SLE患者外周血白细胞内HCMVUL55基因检测的阳性率明显高于健康体检者(P<0.01)。HCMV感染4种检测方法的相关分析显示,细胞内HCMVUL138检测结果与血清HCMVIgG检测有较好的一致性。分析SLE患者外周血白细胞内HCMV感染状况与临床指标的相关性显示,与UL138基因不同,细胞内HCMVUL55检测呈阳性的SLE患者与检测呈阴性的SLE患者比较,存在多项明显差异的临床指标。结论:HCMV感染与SLE存在一定的相关性,但不同检测方法结果差异显著。

关 键 词:人巨细胞病毒  系统性红斑狼疮  聚合酶链式反应  UL55  UL138

Correlation between human cytomegalovirus infection and systemic lupus erythematosus
CHEN Jing,ZHANG Huidi,LOU Weiyang,SHAO Rongrong,ZHANG Lifang,XUE Xiangyang,ZHU Xiaochun.Correlation between human cytomegalovirus infection and systemic lupus erythematosus[J].Journal of Wenzhou Medical College,2014(5):318-323.
Authors:CHEN Jing  ZHANG Huidi  LOU Weiyang  SHAO Rongrong  ZHANG Lifang  XUE Xiangyang  ZHU Xiaochun
Institution:1.Department of Rheumatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 3.The First Clinical Medical College of Wenzhou Medical University, Wenzhou, 325035; 4.Department of Microbiology andImmunology, Wenzhou Medical University, Wenzhou, 325035)
Abstract:Objective: To analyze infective status of the human cytomegalovirus (HCMV) in systemic lupus erythematosus (SLE) patients and explore its relevance to clinical indicators of SLE.Methods: Periph-eral blood leukocytes (PBLs) and serum samples were collected and separated from 60 patients with SLE and 111 healthy individuals. Highly sensitive and speciifc PCR method was used to investigate HCMV-UL55 gene and UL138 gene in PBLs, whereas Roche’s electrochemiluminescence detection kit was used to investigate the HCMV-speciifc serum IgG and IgM. The positive rates and correlation between UL55, UL138 genes detection in PBLs and sera IgG, IgM in SLE patients were explored in SLE patients and healthy individuals. The relation-ship between cellular HCMV infection in PBLs and common clinical indicators of SLE was further analyzed. Results: Agarose gel electrophoresis and sequencing analysis showed established PCR could be used to detect HCMV-UL55 gene and UL138 gene. HCMV IgG in serum and HCMV UL138 gene detection in PBLs were al-most all positive, there was no signiifcant difference between SLE patients and healthy individuals (P〉0.05). On the contrary, the positive rate of HCMV serum IgM test was low; the positive rate of SLE patients (6.67%) was slightly higher than that of the healthy individuals (0.90%) (P=0.052); While the HCMV infection rate by detect-ing HCMV-UL55 gene in PBLs was signiifcantly higher in patients with SLE than that in the healthy control (P〈0.01). Analyzing the correlation among the four detection methods of HCMV infection, the HCMV-UL138 gene detection in PBLs had a good consistency with HCMV-speciifc serum IgG test. Analysis of HCMV infec-tion in PBLs and clinical indicators of SLE patients, unlike HCMV-UL138 gene, a number of clinical indicators were signiifcantly higher in the SLE patients with HCMV-UL55-positive PBLs than that in the SLE patients with HCMV-UL55-nagtive PBLs.Conclusion:There is a certain correlation between HCMV infection and SLE, but the results of different detection methods are signiifcantly different.
Keywords:human cytomegalovirus  systemic lupus erythematosus  PCR
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