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目的探讨UL37外显子3(UL37x3)基因检测在新生儿晚期黄疸巨细胞病毒(Human cytomegalovirus,HCMV)感染诊断中的应用。方法应用巢式PCR法检测2012年1~12月在新生儿科就诊的新生儿晚期黄疸标本UL37x3基因,并通过与HCMV-Ig M、HCMV-DNA荧光定量PCR、HCMV-pp65抗原检测结果做比较,分析UL37x3基因检测在诊断新生儿晚期黄疸HCMV感染的符合程度。结果 1 145例新生儿晚期黄疸血清HCMV-Ig M检测阳性1例,HCMV荧光定量PCR检测阳性24例,HCMV-pp65抗原阳性25例,UL37x3基因扩增阳性25例;2 UL37x3基因检测与HCMV-DNA荧光定量PCR检测结果差异无统计学意义(P=1.000),一致率为96.6%,κ值为0.877;UL37x3基因检测与HCMV-pp65抗原检测结果差异无统计学意义(P=1.000),一致率为95.9%,κ值为0.855;3 UL37x3基因检测用于诊断新生儿晚期黄疸HCMV感染的灵敏度为88.9%,特异度为99.2%,Youden指数为0.88;阳性预测值和阴性预测值分别为0.960和0.975;4 UL37x3基因检测用于诊断新生儿晚期黄疸HCMV活动性感染的灵敏度为88.0%,特异度为97.5%,Youden指数为0.85;阳性预测值和阴性预测值分别为0.880和0.975。结论 UL37x3基因检测适用于临床新生儿晚期黄疸HCMV感染的诊断。
Objective To investigate the application of UL37x3 gene in the diagnosis of neonatal infection with cytomegalovirus (HCMV). Methods Nested PCR was used to detect UL37x3 gene in neonates with neonatal jaundice from January 2012 to December 2012. The results of HCMV-Ig M, HCMV-DNA fluorescence quantitative PCR and HCMV-pp65 antigen test were compared. To analyze the coincidence of UL37x3 gene detection in diagnosing neonatal jaundice HCMV infection. Results The positive rate of serum HCMV-Ig M in 1 145 neonates with late neonatal jaundice was positive in one case. The positive rate of HCMV-pp65 was 25, and the positive rate of UL37x3 was 25. HCMV- The results of DNA fluorescence quantitative PCR showed no significant difference (P = 1.000), the coincidence rate was 96.6% and the kappa number was 0.877. There was no significant difference between the results of UL37x3 and HCMV-pp65 (P = 1.000) Rate of 95.9%, κ value of 0.855; 3 UL37x3 gene test for the diagnosis of neonatal jaundice HCMV infection sensitivity was 88.9%, specificity was 99.2%, Youden index was 0.88; positive predictive value and negative predictive value were 0.960 And 0.975, respectively. 4 The sensitivity, specificity and accuracy of UL37x3 gene detection for detecting active HCMV infection in late neonates with jaundice were 88.0%, 97.5% and Youden index of 0.85 respectively. The positive predictive value and negative predictive value were 0.880 and 0.975, respectively. Conclusion The UL37x3 gene test is suitable for the diagnosis of HCMV infection in clinical neonates with jaundice.