【摘要】 目的探讨US3基因检测在新生儿晚期黄疸巨细胞病毒(human cytomegalovirus,HCMV)感染诊断中的应用。方法应用巢式PCR法检测2012年1-12月在新生儿科就诊的新生儿晚期黄疸标本US3基因,并通过与HCMV-Ig M、HCMV-DNA荧光定量PCR、HCMV-pp65抗原检测结果做比较,分析US3基因检测在诊断新生儿晚期黄疸HCMV感染的符合程度。结果 1145例新生儿晚期黄疸血清HCMV-Ig M检测阳性1例,HCMV荧光定量PCR检测阳性24例,HCMV-pp65抗原阳性25例,US3基因扩增阳性24例;2US3基因检测与HCMV-DNA荧光定量PCR两种检测方法结果差异无统计学意义(P=1.000),一致率为97.2%,κ值为0.900;US3基因检测与HCMV-pp65抗原检测两种检测方法结果差异无统计学意义(P=1.000),一致率为95.2%,κ值为0.828;3US3基因检测用于诊断新生儿晚期黄疸HCMV感染的灵敏度为85.2%,特异度为99.2%,Youden指数为84.4;阳性预测值和阴性预测值分别为0.958和0.967;4US3基因检测用于诊断新生儿晚期黄疸HCMV活动性感染的灵敏度为84.0%,特异度为97.5%,Youden指数为81.5;阳性预测值和阴性预测值分别为0.875和0.967。结论 US3基因检测适用于临床新生儿晚期黄疸HCMV感染的诊断。更多还原

【Abstract】 Objective To explore the application of US3 gene detection in the diagnosis of human cytomegalovirus( HCMV)infection in neonates with late jaundice.Methods Nested PCR was performed to amplify the US3 gene region of clinical strains collected from late jaundice neonates who were hospitalized in neonatal department between January and December 2012.We analyzed the coincidence degree of the results in detecting human cytomegalovirus strains collected from late jaundice neonates by comparing US3 gene detection with serum HCMV-Ig M,HCMV-DNA FQ-PCR,HCMV-pp65 antigenemia assay.Results A total of 145 specimens of late jaundice neonates were detected.The number of positive specimens detected by serum HCMV-Ig M,HCMV-DNA FQ-PCR,HCMV-pp65 antigenemia assay and US3 HCMV-DNA was 1,24,25 and 24 respectively.There was no statistically significant difference in the detection of HCMV infection between US3 gene determination and HCMV-DNA FQ-PCR( P = 1.000),with the consistent rate of 97.2%,and the value of Kappa was 0.900.No statistically significant difference was found in the detection of HCMV infection between US3 gene determination and HCMV-pp65 antigenemia assay( P= 1.000),with the consistent rate of 95.2%,and the value of Kappa was 0.828.The sensitivity,specificity and Youden index of US3 gene detection in diagnosing HCMV infection among late jaundice neonates were 85.2%,99.2% and 84.4 respectively.The positive predictive value( PPV) and negative predictive value( NPV) were 0.958 and 0.967 respectively.The sensitivity,specificity and Youden index of US3 gene detection in diagnosing active HCMV infection among late jaundice neonates were 84.0%,97.5% and 81.5 respectively.The PPV and NPV were 0.875 and 0.967 respectively.Conclusions Detecting US3 gene is conducive to clinical diagnosis of HCMV infection in neonates with late jaundice.更多还原