婴儿血液、尿液及母乳中病毒DNA检测在诊断人巨细胞病毒感染中的应用

Application of HCMV DNA detection in infants ‘blood, urine and mothers’ breast milk in the diagnosis of HCMV infection among infants

摘要:

目的 定量检测疑似人巨细胞病毒(HCMV)感染婴儿血液、尿液及对应母亲乳汁中的HCMV-DNA,评估三者在不同年龄组内辅助诊断HCMV感染的意义。方法 选取170例疑似HCMV感染婴儿,根据年龄分为两组:新生儿组(< 28 d, n=43)和28 d~5个月组(n=127),分别收集血液、尿液及母乳,应用荧光定量聚合酶链式反应法(FQ-PCR)检测HCMV-DNA。结果 新生儿组血液、尿液及母乳HCMV-DNA阳性检出率分别为65.1%、18.6%和93.0%,28 d~5个月组三者检出率分别为64.6%、92.9%和72.4%,28 d~5个月组尿液检出率显著高于新生儿组(P<0.01),而母乳检出率却显著低于新生儿组(P<0.01)。82例血液和尿液HCMV-DNA为阳性的患儿,其尿液HCMV-DNA拷贝数明显高于血液。结论 不同年龄组尿液及母乳中HCMV-DNA检出率不同,根据年龄选择合适的送检标本对提高检出率具有重要意义。

Abstract:

Objective To quantify human cytomegalovirus (HCMV) DNA in the blood and urine of infants of different ages with suspected HCMV infection, and in the breast milk of their mothers, and to evaluate the significance of HCMV DNA detection in the three specimen types in the diagnosis of HCMV infection among infants of different ages. Methods A total of 170 infants with suspected HCMV infection were divided into groups A (<28 days; n=43) and B (28 days to 5 months; n=127) according to their ages. Blood and urine were collected from the infants, and breast milk was collected from their mothers. The specimens were examined by fluorescence quantitative PCR for detection of HCMV DNA. Results In group A, HCMV DNA detection rates in blood, urine and breast milk were 65.1%, 18.6% and 93.0% respectively. In group B, HCMV DNA detection rates in blood, urine and breast milk were 64.6%, 92.9% and 72.4% respectively. HCMV DNA detection rate in urine in group B was significantly higher than in group A (P<0.01), however, HCMV DNA detection rate in mothers' breast milk in group B was significantfly lower than in group A (P<0.01). Among the 82 infants with positive results for blood and urine, the copy number of HCMV DNA in urine was significantly higher than that in blood. Conclusions HCMV DNA detection rates in urine and breast milk are different among infants of different ages, so use of suitable specimens according to age is of great significance for improving detection rate.