异基因外周血干细胞移植后巨细胞病毒感染的早期检测及临床意义

Early Detection of Cytomegalovirus Infection after Allogeneic Peripheral Blood Stem Cell Transplantation and its Clinical Significance

    摘要
  • 摘要: 采用微粒子酶免疫分析法(MEIA)、间接免疫荧光法(IFA)及实时荧光定量PCR法(Real-time FQ-PCR)对42例al-摘要 目的 :选择有效的巨细胞病毒(CMV)早期检测方法用于异基因外周血干细胞移植(allo-PBSCT)。 方法 :lo-PBSCT患者移植后不同时间进行多点动态检测外周血CMV IgM抗体、CMV pp65抗原及CMV DNA负荷量。 结果 :1)移植患者CMV pp65抗原及DNA负荷量的阳性检出率(38.24%,33.82%)明显比IgM抗体阳性检出率(21.50%)高(P<0.05)。2)CMV pp65抗原及DNA负荷量的阳性检出时间(75±64天,60±50天)明显早于IgM(127±73天)(PP<0.05)。 结论 :pp65抗原和DNA负荷量的检测方法适合用于allo-PBSCT术后患者的CMV感染的早期诊断。aGVHD的发生是al-lo-PBSCT患者CMV活动性感染的危险因素。

     

    Abstract: Objective : To determine the most effective method for early diagnosis of CMV infection in recipients of allogeneic peripheral blood stem cell transplants (allo-PBSCT). Methods : Using MEIA, IFA, and real time FQ-PCR methods, we tested 42 patients after allo-PBSCT for CMV IgM antibody, CMV pp65 antigen and CMV DNA in blood at different time points. Results : (1) In these 42 post-transplant patients, the percentages of cases with detectable CMV pp65 antigen (38.24%) and CMV DNA (33.82%) were higher than those of cases with detectable CMV IgM antibody (21.50%) (P <0.05). (2) The appearance of CMV pp65 antigen and CMV DNA (75±64d, 60±50d) was observed earlier than that of CMV IgM antibody (127±73d) (P <0.05). (3)There was a correlation between the presence of CMV reactive infection and acute graft-verse-host disease (P < 0.05). Conclusion : Combining IFA and real time FQ-PCR can make an accurate early diagnosis of CMV infection. CMV infection was a risk factor for the occurrence of GVHD in allo-PBSCT patients.

     

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