肾移植术后巨细胞病毒感染的pp67 mRNA检测及其临床意义

目的　采用核酸基础序列扩增法 (NASBA)检测巨细胞病毒晚期mRNA基因编码的基质蛋白 pp67的表达 ,探讨pp67对肾移植术后HCMV活动性感染及指导抗病毒治疗上的作用。方法　择近期 5 0例肾移植患者进行 pp67检测并随访观察 ,与现用的CMV抗原血症法比较 ,了解pp67与HCMV活动性感染及CMV病的关系。 结果　 5 0例患者中共 5例出现CMV病 ,其CMV Ag与 pp67均呈阳性 ,pp67阳性组中CMV抗原指数显著高于pp67阴性组 ,CMV Ag与pp67平均出现阳性时间无差异 ,以pp67作为抗病毒治疗指标可以明显缩短用药时间 ,pp67比CMV Ag在抗病毒治疗后更早转阴。结论　pp67更准确地反映了肾移植术后HCMV的活动性 ,能更好的指导临床抗病毒用药。

Clinical significance of human cytomegalovirus pp67-mRNA in renal transplant recipients

Objectives To investigate the relation of the human cytomegalovirus pp67-mRNA with the active infection in renal transplant recipients and the role in the direction for antiviral therapy.Methods CMV-Ag,pp67and CMV-DNA were detected in 50 cases of the renal transplant recipients who were followed up to observe the change of pp67 in the cases of the active infection and the CMV disease.Result Among 50 cases,there were 5 cases of CMV diseases,all of them were positive for both pp67 and CMV-Ag.The index of antigenimia in the pp67 positive group was significantly higher than the negative group.The antiviral therapy course could be cut down if using pp67 as the indicator of antiviral therapy.pp67 turned negative more quickly than the CMV-Ag.Conclusion pp67 was exactly reflect the active infection of the HCMV in the renal transplant recipients and more effective in the direction for antiviral therapy.