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目的探讨外周血白细胞人巨细胞病毒(HCMV)pp65抗原血症检测和UL83基因检测对肾移植术后HCMV感染的诊断价值和临床意义。方法对77例肾移植受者术后定期随访患者外周血进行HCMV感染检测,分别进行外周血白细胞HCMV pp65抗原血症实验和PCR技术检测HC-MV UL83基因,比较两种方法的诊断准确性。结果 77例肾移植患者中HCMV pp65抗原血症阳性者13例,阳性率为16.9%;PCR法检测HCMV UL83基因阳性者15例,阳性率为19.5%。其中16例临床诊断为HCMV感染,其中7例为症状性感染,9例为无症状性感染。阳性符合率75%,阴性符合率94%。HCMV pp65检测的阳性率与PCR检测的阳性率比较,Kappa值为0.826(>0.75),差异有显著性(P<0.01),说明两种方法检测结果一致性较好。结论外周血白细胞pp65抗原血症实验和PCR技术的联合应用对监测HCMV活动性感染、临床疗效及预后更加客观、准确。
Objective To investigate the diagnostic value and clinical significance of detection of HCMV pp65 antigens and peripheral blood leukocyte cytomegalovirus (HCMV) in patients with HCMV infection after renal transplantation. Methods HCMV infection was detected in peripheral blood of 77 renal transplant recipients who were followed up regularly. HCMV pp65 antigenemia test and PCR technique were used to detect HC-MV UL83 gene respectively. The diagnostic accuracy of the two methods was compared. Results The positive rate of HCMV pp65 antigens in 77 renal transplant recipients was 13.9% (positive rate was 16.9%). The positive rate of HCMV UL83 gene detected by PCR was 15.5% (positive rate was 19.5%). Among them, 16 cases were clinically diagnosed as HCMV infection, of which 7 were symptomatic and 9 were asymptomatic. The positive coincidence rate of 75%, the negative coincidence rate of 94%. The positive rate of HCMV pp65 was higher than that of PCR. The Kappa value was 0.826 (> 0.75), the difference was significant (P <0.01), indicating that the consistency of the two methods was good. Conclusions The combination of peripheral blood leukocytes pp65 antigenemia test and PCR technique is more objective and accurate in monitoring HCMV active infection.