HCMVpp65抗原和IgM抗体检测诊断儿童HCMV活动性感染的比较

目的：比较人巨细胞病毒(HCMV)pp65抗原(以下简称pp65)检测和血清HCMV-IgM抗体(以下简称IgM抗体)检测两种方法对儿童HCMV活动性感染的诊断实用意义。方法：采集临床疑似HCMV活动性感染儿童血标本(共251份)，分离血浆和多形核白细胞，分别用于IgM抗体检测和pp65检测。同时进行荧光定量PCR检测HCMVDNA，与pp65抗原作平行比较。结果：pp65抗原检测的结果与IgM抗体检测的符合率为73.3％。与HCMV DNA检测相比pp65抗原检测法的符合率、特异度和敏感度分别为85．5％，85．2％和86．2％。而且高pp65抗原血症与患者的临床症状密切相关。结论：pp65抗原血症反映该病毒活动状况，可监测HCMV活动性感染。由于儿童患者还存在原发感染的可能性，所以．联合HCMV-IgM的监测来提高临床的诊断率。

Comparison of the human cytomegalovirus pp65 antigen test and the HCMV-specific IgM assay in the diagnosis of cytomegalovirus active infection in children

Objective To compare the diagnostic efficacy of the human cytomegalovirus (HCMV) pp65 antigen (abbreviated pp65 as followed) test and the HCMV-specific IgM (abbreviated IgM as followed) assay in the diagnosis of active HCMV infection in children. Methods Two hundred and fifty-one blood samples obtained from the children with suspected HCMV infection were collected. The plasma was separated from the poly-morphonuclear cells. The former was used for the IgM assay and the latter was used for the pp65 antigen test. The HCMV DNA was simultaneously detected by the fluorescent quantitative PCR assay in parallel comparison with the pp65 antigen test. Results The correspondence of the pp65 antigen test and the IgM assay was 73.3%.Compared with the HCMV DNA by the quantitive PCR,the correspondence, the specificity and the sensitivity of the pp65 antigen in the detection of the active HCMV infection were 85.5%, 85.2% and 86.2% respectively. Furthermore, the number of the pp65 antigen-positive cells detected by the pp65 antigen test was closely correlated with the clinical symptoms. Conclusions The pp65 antigen assay can reflect the level of HCMV and predict the active HCMV infection in children. The IgM assay can also be used as an assistant diagnostic tool for active cytomegalovirus infection in children, which is suggested to be applied in combination with pp65 antgen test.