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目的 了解系统性红斑狼疮 (systemiclupuserythematosus,SLE)患儿活动性人类巨细胞病毒 (humancytomegalovirus,HCMV)感染的状况 ,并比较不同实验室检测方法的诊断价值。方法 实验组观察了 2 1例初诊为SLE并接受免疫抑制治疗的患儿 ,对照组观察了 2 1例免疫力正常的骨科患儿。治疗前后应用间接免疫荧光法检测外周血多形核白细胞 (polymorphonuclearleukocytes,PMNLs)中的HCMVpp6 5抗原和p72抗原 ,PCR方法检测血清中的HCMVDNA ,ELISA方法检测血清中的HCMVIgM和IgG抗体。结果 实验组活动性HCMV感染发生率为 2 9% (6 /2 1) ,4例发生于免疫抑制治疗后 ,另外 2例发生于免疫抑制治疗前 ,对照组无 1例发生活动性感染 ,两组相比差异有显著性(P =0 0 2 7)。实验组各项实验室检测的阳性率分别为 :pp6 5 2 4% (5 /2 1)、p72 14% (3/2 1)、DNA 43 % (9/2 1)、IgM 10 % (2 /2 1)、IgG 91% (19/2 1)。实验组各项实验室检测方法诊断活动性HCMV感染的敏感性分别为 :pp6 5 83% (5 /6 )、p72 5 0 % (3/6 )、DNA 10 0 % (6 /6 )、IgM 33% (2 /6 )、IgG(双份血清抗体滴度呈≥ 4倍增高 ) 5 0 % (3/6 )。特异性除PCR方法为 80 % (12 /15 )外 ,其余均为 10 0 % (15 /15 )。结论 SLE患儿活动性HCMV感染发生率较免疫力正常的
Objective To investigate the status of human cytomegalovirus (HCMV) infection in children with systemic lupus erythematosus (SLE) and to compare the diagnostic value of different laboratory tests. Methods In the experimental group, 21 children with newly diagnosed SLE and immunosuppressive therapy were enrolled in the study. Twenty-one children with orthopedic immunity were observed in the control group. Serum HCMV DNA was detected by indirect immunofluorescence assay and HCMVpp6 5 antigen and p72 antigen in peripheral blood polymorphonuclear leukocytes (PMNLs) before and after treatment. The serum HCMV IgG and IgG antibodies were detected by ELISA. Results The incidence of active HCMV infection was 29% (6/21) in experimental group, 4 cases occurred after immunosuppressive therapy, and the other 2 cases occurred before immunosuppressive therapy. There was no active infection in control group, and two There was significant difference between the two groups (P = 0 0 2 7). The positive rates of various laboratories in the experimental group were pp6 5 2 4% (5/2 1), p72 14% (3/2 1), DNA 43% (9/2 1), IgM 10% (2) / 2 1), IgG 91% (19/2 1). The sensitivities of laboratory tests to active HCMV infection were pp6 5 83% (5/6), p72 50% (3/6), DNA 10 0% (6/6), IgM 33% (2/6), IgG (double serum antibody titer ≥ 4 times higher) 50% (3/6). The specificity of the PCR except 80% (12/15), the rest were 10 0% (15/15). Conclusion The incidence of active HCMV infection in children with SLE is more normal than that of normal immunity