【摘要】 目的探讨检测巨细胞病毒(CMV)DNA及其即刻早期抗原(IE)、巨细胞病毒pp65和pp67抗体对肾移植受者术后巨细胞病毒感染早期诊断的临床应用价值。方法按肾移植术受者术后3个月外周血是否出现CMV抗原,将71例患者分为CMV感染组(56例)和CMV未感染组(15例),肾移植术受者手术前和术后第1个月每周检查1次,第2、3个月每2周检查1次外周血巨细胞病毒pp65和巨细胞病毒pp67、即刻早期抗原(immediate early antigen,IE),巨细胞病毒DNA和IgM、IgG,共8次;以监测与分析评价肾移植术受者手术前后各项指标变化。结果肾移植术前71例肾移植受者PP65、PP67、IE、CMV DNA均为阴性;肾移植术后CMV感染组的pp65、pp67、IE、CMV DNA阳性率分别为67.8%(38/56)、66.1%(37/56)、64.2%(36/56)和48.2%(27/56),CMV未感染组4项指标值分别为0%、0%、13.3%(2/15)、和0%,两组差异均有统计学意义(P均<0.01)。肾移植术后CMV感染组(56例)和CMV未感染组(15例)CMV IgG均为阳性,而IgM阳性率在CMV感染组仅为3.5%(2/56),在CMV未感染组为0%,IgM表达率在CMV感染组和未感染组无统计学差异(P>0.05)。观察期内感染组与未感染组相比,术后CMV pp65,pp67,CMV DNA和IE指标出现阳性的例数及阳性出现的具体时间均有显著性差别(P均<0.01),而IgM和IgG则均无显著性差别(P均>0.05)。结论肾移植术后患者外周血CMV DNA,IE,pp65和pp67抗原检测阳性与其术后巨细胞病毒感染相关。检测CMV DNA、IE、pp65和pp67抗原可能更早更准确反映器官移植术后CMV活动性感染。而CMV IgG和IgM不能作为肾移植后患者CMV感染的诊断指标。更多还原

【Abstract】 Objective To study the changes of IE,CMVpp6,CMVpp67,IgM,IgG and CMV DNA and the early diagnosis of CMV in renal transplantation.Methods Three months after renal transplantation,71 kidney transplants were divided into two groups(Cytomegalovirus infection positive group,56;negative group,15).Before and after operation(one month,two months and three months),the changes of IE,CMVpp6,CMVpp67,IgM,IgG and CMV DNA were detected by serology in peripheral blood.Results Before transplantation,CMV IgG was positive in 71recipients(100%),but PP65,PP67 and IgM were all negative.In the infection group,the positive rate of PP65,pp67,IE and CMV DNA was 67.8%(38/56),66.1%(37/56),64.2%(36/56)and 48.2%(27/56)respectively.Between the infection group,and the noinfection group,there was statistical difference in the monitoring positive time of pp65,pp67,CMV DNA and IE(P<0.01,respectively),but no statistical difference in the monitoring positive time of IgM and IgG(P>0.05,respectively).Conclusion CMV DNA,IE,pp65 and pp67may be directly related to cytomegalovirus infection in renal transplantation.Combined detection of CMV DNA,IE,pp65 and pp67may be clinically useful diagnostic markers for CMV infection in renal transplantation.更多还原