【摘要】 目的探讨早期检测CMV感染的有效方法。方法应用Real-time Q-PCR技术对15例allo-HSCT患者的外周血自移植前15d始进行CMV-DNA的动态监测。结果 15例患者及供者于allo-HSCT术前均未检测到CMV-DNA,移植后连续动态监测患者CMV-DNA。但1例患者出现CMV肺炎的典型临床表现,标本行PP65抗原血症检测呈阳性反应,另1例患者疑诊CMV膀胱炎,多次检测均呈阴性反应,但抗CMV治疗有效。结论 allo-HSCT患者有其特殊性,患者的免疫力重度低下,骨髓处于不同程度的抑制状态,病毒负荷较低,因而应根据具体情况采用适宜的标本及实验方法。对CMV-DNA阳性患者及具有CMV危险因素的患者宜尽早开始干预疗。更多还原

【Abstract】 Objective To evaluate the clinical significance of Real-time Quantitative Polymerase Chain Reaction(Real-time Q-PCR) in monitoring Cytomegalovirus(CMV) infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT),and seek for the effective method of detecting and managing CMV infection.Methods Real-time Q-PCR was performed for monitoring CMV infection in 15 recipients since-15d.Ganciclovir and foscarnet are the approved drugs for treating CMV disease.Either alone in combination with intravenous immunoglobulin had been used for prevention.The two drugs and immunoglobulin had been used in combination as therapy for established CMV disease.Results There were not CMV-DNA detected in both 15 recipients and donors before allo-HSCT,and the monitoring tests were also negative after allo-HSCT.But one patient presented typical symptoms of CMV pneumonitis despite a negative PCR assay,in this case,PP65 antigenemia was found to be positive.Another patient was suspected to has CMV cystitis,but several detecting results wre all negative.Conclusion To allo-HSCT recipients the Real-time Q-PCR based on blood is not correlated well with CMV disease.This is due to the immunosuppress,bone marrow suppression and low virus load.So appropriate samples and detecting methods should be used accordingly.It’s important to initiate preemptive therapy when CMV-DNA is positive or patients have high CMV risk factors.更多还原