ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (2): 129-132.doi: 10.3969/j.issn.1674-3865.2018.02.012

• 临床研究 • 上一篇    下一篇

荧光定量PCR检测在人巨细胞病毒IgM阴性婴儿巨细胞病毒感染诊断中的意义

谢利波，刘敏，王敏   

  1. 443003 湖北 宜昌，三峡大学第一临床医学院，宜昌市中心人民医院儿科（谢利波，王敏）；宜昌市中心人民医院检验科（刘敏）
  • 出版日期:2018-04-25 发布日期:2018-11-19
  • 通讯作者: 谢利波，E-mail：13227279147@163.com
  • 作者简介:谢利波(1979-)，男，医学硕士，主治医师。研究方向：儿童感染性疾病与呼吸系统疾病的诊治

Significance of FQ-PCR detection in diagnosis of cytomegalovirus infection in HCMV-IgM negative infants

XIE Libo，LIU Min，WANG Min   

  1.  Department of Pediatrics，the First Clinical Medical College of China Three Gorges University，Yichang 443003，China
  • Online:2018-04-25 Published:2018-11-19

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摘要：
目的
探讨在人巨细胞病毒（HCMV）-IgM阴性情况下，联合尿液及乳汁HCMV-DNA荧光定量检测在婴儿巨细胞病毒感染诊断中的意义。
方法
选择2013年1月至2015年12月宜昌市中心人民医院儿科收治疑似HCMV感染患儿304例，根据患儿主诉及体格检查、临床第一诊断将疑似HCMV感染患儿分为肝炎组186例、肺炎组71例及其他组（主诉为发热、腹泻等）47例。分析各组患儿尿液及母乳的HCMV-DNA荧光定量PCR的结果。
结果
肝炎组和其他组尿液HCMV-DNA检出率分别为41.94%（78/186）、51.06%（24/47），显著低于母乳53.76%（100/186）、72.34%（34/47），差异有统计学意义（P<0.05）。肺炎组尿液HCMV-DNA检出率与母乳比较差异无统计学意义（P>0.05）。3组间尿液和母乳中HCMV-DNA阳性率比较差异无统计学意义（P>0.05）。检出尿液与乳汁同时阳性88例（28.95%），乳汁阳性174例（57.24%），尿液阳性141例（46.38%）。
结论
母乳是婴儿HCMV感染的重要传染源，在患儿HCMV-IgM抗体阴性情况下，联合检测尿液及乳汁HCMVDNA能提高检出阳性率，避免漏检。

关键词: 巨细胞病毒感染, 尿液, 母乳, 婴儿

Abstract:
objective
To explore the significance of combined quantitative detection of urine and milk HCMV-DNA in the diagnosis of cytomegalovirus infection in infants with negative  human cytomegalovirus(HCMV)-IgM.
Methods
A total of 304 children with suspected HCMV infection treated in Yichang Central People's Hospital from Jan. 2013 to Dec. 2015 were chosen. According to the children's chief complaint, physical examination and clinical first diagnosis, these children were divided into 3 groups: hepatitis group(786 children),pneumonia group(71 children) and a third group(47 children whose chief complaint was fever and diarrhea). The results of HCMV-DNA fluorescence quantitative PCR in urine of the children and breast milk of mothers were analyzed.
Results
The detection rate of urine HCMV-DNA in hepatitis group and a third group was 41.94%(78/186) and 51.06%(24/47), which was significantly lower than that in breast milk(53.76%,100/186;72.34%,34/47), the difference being statistically significant(P<0.05). There was no significant difference between the urine HCMV-DNA detection rate and that of the breast milk in the pneumonia group(P>0.05). There was no significant difference in the positive rate of HCMV-DNA in urine and breast milk among the three groups(P>0.05). The urine and milk were both positive in 88 cases(28.95%), milk positive in 174 cases(57.24%), urine positive in 141 cases(46.38%).
Conclusion
Breast milk is an important source of HCMV infection in infants. Under the condition of negative HCMV-IgM antibody, combined detection of HCMV-DNA in urine and milk can increase the positive rate of detection and avoid missed detection.

Key words: Cytomegalovirus infection, Urine, Breast milk, Baby