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目的 对不同种类标本应用PCR检测巨细胞病毒(cytomegalovirus,CMV)DNA,并与外周血白细胞CMV抗原检测比较,以了解PCR方法在诊断白血病患儿活动性CMV感染时的意义。方法 实验组为31例白血病患儿,对照组为31例免疫功能正常儿童,两组儿童的年龄、性别无差异。应用PCR方法检测血清、尿液和脑脊液CMVDNA,间接免疫荧光方法检测外周血白细胞CMV抗原,ELISA方法检测血清抗CMVIgG。结果 实验组CMV感染率为100%(31/31例CMVIgG阳性),对照组CMV感染率为839%(26/31例CMVIgG阳性),两者之间无差异(P=1)。实验组检测CMV抗原,有9例阳性且均发生了活动性CMV感染,活动性感染率为291%,对照组活动性感染率为0%,两者之间差异有非常显著性(P=0002)。与CMV抗原检测相比,PCR方法检测尿、血清和脑脊液CMVDNA诊断白血病儿童活动性CMV感染的敏感性为(889～100)%,特异性为(682～818)%。结论 白血病患儿易发生活动性CMV感染。在诊断CMV感染时,应用PCR方法检测CMVDNA的敏感性较高,但要注意区分活动性感染和潜伏性感染。
Objective To detect the cytomegalovirus (CMV) DNA in different types of specimens by PCR and compare with the detection of CMV antigen in peripheral leukocytes to understand the significance of PCR in the diagnosis of active CMV infection in children with leukemia. Methods The experimental group was 31 children with leukemia and 31 healthy children with normal immune function in the control group. There was no difference in age and sex between the two groups. Serum, urine and cerebrospinal fluid (CMV DNA) were detected by PCR, CMV antigens were detected by indirect immunofluorescence and serum anti-CMV IgG was detected by ELISA. Results The infection rate of CMV in experimental group was 100% (31/31 CMVIgG positive), while that of control group was 839% (26/31 CMVIgG positive). There was no difference between the two groups (P = 1). In the experimental group, CMV antigen was detected in 9 cases, and all of them were active CMV infection. The rate of active infection was 291% and that of the control group was 0%. There was a significant difference between the two groups (P = 0002 ). Compared with the detection of CMV antigen, PCR detection of CMV infection in urine, serum and cerebrospinal fluid in children with active CMV infection was (889 ~ 100)% with a specificity of (682 ~ 818)%. Conclusion Leukemia is prone to active CMV infection in children. In the diagnosis of CMV infection, the application of PCR detection of high sensitivity of CMVDNA, but should pay attention to distinguish between active infection and latent infection.