【摘要】 目的探讨肾移植受者巨细胞病毒(cytomegalovirus,CMV)隐性感染的筛查方法,为临床早期发现CMV活动性感染提供诊断依据。方法收集笔者医院2009年10～12月期间门诊随访233例肾移植受者外周静脉血标本450份,分别采用实时荧光定量PCR(Real-time PCR)、巢式PCR(nPCR)以及酶联免疫吸附(ELISA)法对标本进行检测,同时采用ELISA法检测他克莫司(Tac)浓度。结果 233例肾移植受者CMV-IgG均为阳性,CMV-IgM则均为阴性;Real-time PCR技术检测CMV-DNA阳性85例(36.48%),以低拷贝数为主。nPCR技术检测CMV-DNA阳性10例(4.29%),两种技术检测总阳性率存在显著性差异(P<0.05);随着Tac药物浓度升高,CMV-DNA阳性率呈增高趋势,药物高浓度组CMV-DNA阳性率高于低浓度组(P<0.05)。结论 Real-time PCR是筛查肾移植受者CMV隐性感染较为理想的方法,尤其在受者药物浓度偏高时更具有临床应用价值。更多还原

【Abstract】 Objective To discuss the method of screening cytomegalovirus recessive infection in renal transplant recipients,providing a reference basis for early detection of cytomegalovirus active infection.Methods Totally 450 samples from 233 patients from 2009 October to December in our transplant center were detected for cytomegalovirus by real-time PCR,nPCR and ELISA,detected for tacrolimus concentration by ELISA at the same time.Results Among the 233 cases of renal transplant recipients,all of CMV-IgG were detected positive,and CMV-IgM negative,in which 36.48% of the recipients were positive to real-time PCR and 4.29% were positive to nPCR.The former had a higher sensitivity than the latter(P<0.05).The contents of positive CMV-DNA were mainly low.CMV-DNA was positive trends to be higher.With the Tac drug concentration increasing,the posiative rate of CMV-DNA in drug high concentrations group were higher than low concentration group.Conclusion Real-time PCR is a more ideal method for screening CMV recessive infection in renal transplant recipients,especially it has more clinical application value in the recipients when they have more high drug concentration.更多还原