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本研究探讨同种异基因造血干细胞移植(allo-HSCT)后早期有效检测巨细胞病毒(CMV)感染的方法。应用荧光定量PCR和ELISA试剂盒分别检测19名allo-HSCT受者,214份标本的血浆DNA负荷量和血清IgM抗体,同时应用流式细胞术检测188份标本白细胞pp65抗原。结果表明:pp65抗原、DNA定量和IgM抗体的阳性检出率分别为30.85%(58/188)、35.51%(76/214)和13.08%(28/214),连续阳性病例和临床诊断的符合率分别为7/8、7/8和3/8。DNA定量与pp65抗原阳性检出率的差别无统计学意义(P>0.05),但两种检测方法有明显的相关性(P<0.05)。IgM抗体阳性检出率明显低于DNA定量和pp65抗原,其差别均有统计学意义(P<0.05),与另两种检测方法虽有关系,但不密切。结论:流式细胞术和荧光定量PCR检测allo-HSCT受者CMV早期感染可靠、简便快速,值得临床推广使用。
This study was aimed to investigate the early detection of cytomegalovirus (CMV) infection in allo-HSCT after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twenty-nine samples of allo-HSCT recipients, 214 DNA load and serum IgM antibody were detected by real-time quantitative PCR and ELISA kit, and 188 samples of pp65 antigen were detected by flow cytometry. The results showed that the positive rates of pp65 antigen, DNA quantification and IgM antibody were 30.85% (58/188), 35.51% (76/214) and 13.08% (28/214), respectively. The coincidence of consecutive positive cases and clinical diagnosis Rates were 7/8, 7/8 and 3/8 respectively. There was no significant difference between DNA quantification and pp65 antigen positive detection rate (P> 0.05), but there was a significant correlation between the two methods (P <0.05). The positive detection rate of IgM antibody was significantly lower than that of DNA quantification and pp65 antigen (P <0.05), which was not related to the other two detection methods. Conclusion: Flow cytometry and real-time PCR detection of allo-HSCT recipients CMV early infection reliable, simple and rapid, worthy of clinical promotion and use.