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本研究比较巨细胞病毒(CMV)定量PCR检测和CMV-pp65抗原检测在异基因造血干细胞移植CMV感染中的诊断价值。以84例异基因造血干细胞移植患者为研究对象,自预处理开始每周对患者EDTA抗凝外周血血标本进行CMV-pp65抗原及CMV定量PCR动态检测,直至出院,比较观察两者在诊断CMV感染中的作用。结果表明:84例移植患者的732份系列血标本中,26例移植后检出CMV定量PCR阳性,检出率30.95%,其中9例为CMV血症,13例为CMV病,检出中位时间为37.1(7-105)天;22例CMVpp65抗原检测阳性,检出率26.19%,检出中位时间为46.6(10-128)天;所有CMV-pp65抗原检测阳性患者CMV定量PCR均为阳性,4例CMV定量PCR阳性但CMV-pp65抗原检测阴性患者均未发展为CMV病。CMV病多出现于CMV定量PCR中等至高拷贝数或中等至高水平病毒血症(CMV-pp65抗原)病例中。治疗后CMV定量PCR转阴中位时间为17.5(11-28)天,CMV-pp65抗原转阴中位时间为10.0(7-21)天。结论:CMV定量PCR和CMV-pp65抗原检测均能作为异基因造血干细胞移植CMV感染早期诊断的有效手段,CMV定量PCR更敏感,CMV-pp65抗原检测更特异,两者同时使用能更有效地提高CMV感染诊断水平,监控其发生发展。
This study compared cytomegalovirus (CMV) quantitative PCR detection and CMV-pp65 antigen detection in allogeneic hematopoietic stem cell transplantation CMV infection in the diagnostic value. To 84 patients with allogeneic hematopoietic stem cell transplantation as the research object, weekly anticoagulant blood samples from patients with EDTA anticoagulation CMV-pp65 antigen and CMV quantitative PCR dynamic detection until discharge, compared the two in the diagnosis of CMV The role of infection. The results showed that among the 732 blood samples collected from 84 patients, the positive rate of CMV was detected in 26 cases after transplantation. The detection rate was 30.95%, of which 9 were CMV and 13 were CMV. The median The detection time was 37.1 (7-105) days. The positive rate of CMVpp65 antigen in 22 cases was 26.19%, and the median time was 46.6 (10-128) days. The CMV quantitative PCR of all CMV-pp65 antigen positive patients was Positive, 4 cases of CMV quantitative PCR positive, but CMV-pp65 antigen negative patients did not develop CMV disease. Most cases of CMV disease appear in cases of moderate to high copy number CMV quantitative PCR or moderate to high levels of viremia (CMV-pp65 antigen). After treatment, CMV quantitative PCR negative median time was 17.5 (11-28) days, CMV-pp65 antigen negative median time was 10.0 (7-21) days. CONCLUSION: Both CMV quantitative PCR and CMV-pp65 antigen detection can be used as an effective method for early diagnosis of CMV infection in allogeneic hematopoietic stem cell transplantation. CMV quantitative PCR is more sensitive and CMV-pp65 antigen test is more specific, and both can be more effectively used CMV infection diagnosis, monitoring its occurrence and development.