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目的了解合肥地区正常顺产新生儿先天性人巨细胞病毒(human cytomegalovirus,HCMV)感染情况,并探讨脐带血血浆在HCMV垂直传播中的意义。方法自合肥市妇幼保健院采集51份新生儿脐带血标本,将处理后得到的脐带血白细胞及血浆分别提取DNA后,进行HCMV UL55基因的巢式PCR检测,并随机抽取其中18份脐带血白细胞进行HCMV pp65抗原血症检测。结果 51份新生儿脐带血白细胞HCMV UL55 DNA阳性数为16份,阳性率为31.4%;同时进行检测的51份脐带血血浆HCMV UL55 DNA阳性数为17份,阳性率为33.3%,新生儿脐带血白细胞与血浆的标本阳性率差异无统计学意义(2=0.00,P=1.000)。以新生儿脐带血白细胞HCMVUL55 DNA巢式PCR结果为标准,利用血浆巢式PCR检测的灵敏度为75.0%(12/16),特异度为85.7%(30/35),阳性预测值为70.6%(12/17),阴性预测值为88.2%(30/34)。随机抽取其中18份新生儿脐带血白细胞进行pp65抗原血症检测,阳性标本数为6份,阳性率为33.3%;与此18份血浆DNA巢式PCR结果相比较,两者差异无统计学意义(2=0.00,P=1.000)。结论脐带血血浆在HCMV垂直传播中起携带并传播病毒的作用。
Objective To investigate the infection of human cytomegalovirus (HCMV) in normal newborn infants in Hefei and to explore the significance of cord blood plasma in the vertical transmission of HCMV. Methods Fifty-one neonatal umbilical cord blood samples were collected from Hefei MCH hospital. DNA was extracted from umbilical cord blood leukocytes and plasma after treatment, respectively, and nested PCR was performed on HC55V UL55 gene. 18 of the cord blood leukocytes HCMV pp65 antigenemia test. Results The positive numbers of HCMV UL55 DNA in 51 newborn umbilical cord blood cells were 16 and the positive rate was 31.4%. The positive number of HCMV UL55 DNA in 51 umbilical cord blood samples tested simultaneously was 17 and the positive rate was 33.3%. Neonatal umbilical cord There were no significant differences in the positive rates of leukocyte and plasma (2 = 0.00, P = 1.000). The sensitivity of nested PCR was 75.0% (12/16), the specificity was 85.7% (30/35) and the positive predictive value was 70.6% (based on the result of neonatal umbilical cord blood HCMVUL55 DNA nested PCR) 12/17), negative predictive value was 88.2% (30/34). 18 neonatal umbilical cord blood leukocytes were randomly selected for the detection of pp65 antigenemia, the positive number was 6 and the positive rate was 33.3%. There was no significant difference between these 18 DNA nested PCR results (2 = 0.00, P = 1.000). Conclusion Umbilical cord plasma plays a role in carrying and transmitting the virus in the vertical transmission of HCMV.