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目的 :采用酶联免疫吸附法 (ELISA)、定性及定量聚合酶链反应法 (PCR)监测肾移植术后巨细胞病毒(Cytomegalovirus,CMV)活动性感染 ,探讨不同检测方法在肾移植术后CMV活动性感染防治中的价值。 方法 :于移植前、后抽取 1 0 8例肾移植受者的外周静脉血 ,采用ELISA法、定性及定量PCR法检测血液中CMV IgM及CMV DNA ;对于CMV活动性感染者应用丙氧鸟苷治疗。 结果 :术后 58例患者发生CMV活动性感染。诊断CMV活动性感染的灵敏性和特异性 :ELISA法为 1 9%和 1 0 0 % ;定性PCR法为 71 %和 58% ;定量PCR法为 93 %和 1 0 0 %。在CMV活动性感染临床症状出现前 ,定性及定量PCR法检测CMV DNA的阳性率分别为 2 2 %和 86 % ,而ELISA法检测CMV IgM无一例阳性 ;用丙氧鸟苷治疗后 ,55例有效 ,3例无效。 结论 :与ELISA法及定性PCR法比较 ,定量PCR法能够更灵敏、特异的监测肾移植术后CMV活动性感染 ,并可用于评价丙氧鸟苷的抗病毒疗效 ,指导CMV活动性感染的治疗
OBJECTIVE: To monitor the cytomegalovirus (CMV) active infection after renal transplantation by ELISA and qualitative and quantitative polymerase chain reaction (PCR), and to explore the effect of different detection methods on CMV after renal transplantation The value of active infection control. Methods: Peripheral venous blood of 108 renal transplant recipients was collected before and after transplantation. CMV IgM and CMV DNA in blood were detected by ELISA and qualitative and quantitative PCR, respectively. For patients with active CMV, gonadotropin treatment. Results: Fifty-eight patients developed CMV active infection. Sensitivity and specificity for diagnosis of active CMV infection were 19% and 100% for the ELISA, 71% and 58% for the qualitative PCR, and 93% and 100% for the quantitative PCR. Before the onset of clinical symptoms of CMV active infection, the positive rates of qualitative and quantitative PCR for detection of CMV DNA were 22% and 86%, respectively, while no CMV IgM was detected by ELISA. After treatment with ganosine, 55 Effective, 3 cases invalid. Conclusion: Compared with ELISA and qualitative PCR, quantitative PCR method can be more sensitive and specific monitoring of CMV infection after renal transplantation, and can be used to evaluate the antiviral effect of ganciclovir and guide the treatment of active CMV infection