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目的以巢式PCR检测新生儿脐带血中单纯疱疹病毒1型(HSV-1)gD基因和HSV-2 gG基因并用测序确认的结果为参比,分析利用新生儿咽拭子检测相应病毒基因在诊断新生儿HSV先天性感染中的意义。方法采集顺产新生儿抗凝脐带血35份,同时采集咽拭子35份。采用检测HSV-1 gD基因和HSV-2 gG基因的PCR法检测新生儿脐带血和咽拭子标本DNA,阳性扩增结果确认后,比较咽拭子检测与脐带血检测结果,以及咽拭子检测特异性、灵敏度、阳性预测值和阴性预测值4个指标,分析新生儿咽拭子检测能否为诊断HSV先天性感染提供依据。结果 35份脐带血中HSV-1阳性率28.6%(10/35),咽拭子HSV-1阳性率25.7%(9/35),两者差异无统计学意义。脐带血中HSV-2阳性率22.8%(8/35),咽拭子HSV-2阳性率28.6%(10/35),两者差异无统计学意义。HSV-1两种标本检测一致率68.6%;HSV-2两种标本一致率77.1%。咽拭子HSV-1、HSV-2检测灵敏度分别为40.0%和62.5%,特异性分别为80.0%和84.6%,阳性预测值分别为44.4%和50.0%,阴性预测值分别为76.9%和88.0%。结论以新生儿脐带血单核细胞中HSV-1 gD基因和HSV-2 gG基因检测结果为参比,新生儿咽拭子检测与脐带血检测具有较高的一致性,表明咽拭子检测用于新生儿HSV先天性感染诊断具有重要的临床应用价值。
Objective To detect the herpes simplex virus 1 (HSV-1) gD gene and HSV-2 gG gene in neonatal umbilical cord blood using nested PCR and to compare the results of sequencing confirmation. The detection of the corresponding viral genes in neonates with throat swab Diagnosis of neonatal HSV congenital infection in the significance. Methods Totally 35 neonates with anticoagulant umbilical cord blood were collected and 35 throat swabs were collected simultaneously. The neonatal umbilical cord blood and throat swab DNA were detected by PCR method using HSV-1 gD gene and HSV-2 gG gene. After confirming the positive amplification results, the results of throat swab and cord blood test, throat swab The detection of specificity, sensitivity, positive predictive value and negative predictive value four indicators, analysis of neonatal throat swab can provide a basis for the diagnosis of HSV congenital infection. Results The positive rate of HSV-1 in 35 cord blood was 28.6% (10/35), and the positive rate of HSV-1 in throat swab was 25.7% (9/35). There was no significant difference between the two. The positive rate of HSV-2 in cord blood was 22.8% (8/35), and the positive rate of HSV-2 in throat swab was 28.6% (10/35). There was no significant difference between them. HSV-1 two specimens of the detection rate was 68.6%; HSV-2 two specimens of the same rate of 77.1%. The sensitivity of HSV-1 and HSV-2 in throat swab was 40.0% and 62.5% respectively, the specificity was 80.0% and 84.6% respectively, the positive predictive value was 44.4% and 50.0% respectively, and the negative predictive values were 76.9% and 88.0 %. Conclusion The detection results of HSV-1 gD gene and HSV-2 gG gene in cord blood mononuclear cells of neonates are used as reference. The detection of throat swabs and umbilical cord blood in neonates has high consistency, indicating that the detection of throat swabs In neonatal HSV congenital infection diagnosis has important clinical value.