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目的建立一种早期、快速诊断 人巨细胞病毒(human cytomegalovirus, HCMV)感染的抗原检测方法,以了解肾移植术 后受者的HCMV感染情况并探讨其临床意义。方法利用 抗HCMV前早期抗原和早期抗原的单克隆抗体,建立了免疫组化Envision~(TM)二步法。用 于 检测外周血多形核白细胞(PMNL)中HCMV抗原(前早期抗原和早期抗原),诊断HCMV活动性感 染。结果检测肾移植术后受者86例,HCMV抗原阳性39 例,阳性率45.3%。抗原阳性细胞数平均为16.5 个/5万PMNL。其中,HCMV病患者和无症 状HCMV感染者平均分别为24.5±18.2个/5万PMNL和12.0±10.6个/5万PMNL。15名 正常 人(抗HCMV血清抗体阴性)作为对照同时检测HCMV抗原,结果均为阴性。结论该法具有简便、快速等优点,且能区分潜伏感染和活动性感染,适 用于临床对HCMV感染的早期快速诊断和作为指导排斥治疗以及判断预后的主要手段,有推广 应用价值。
Objective To establish an early and rapid method for antigen detection of human cytomegalovirus (HCMV) infection to understand the HCMV infection in recipients after renal transplantation and to explore its clinical significance. Methods Immunohistochemistry (Envision TM) two-step method was established using monoclonal antibodies against pre-HCMV pre-antigens and early antigens. Used to detect HCMV antigens (pre-early antigens and early antigens) in peripheral blood polymorphonuclear leukocytes (PMNL) to diagnose active HCMV infection. Results 86 cases of renal transplant recipients, HCMV antigen positive in 39 cases, the positive rate of 45.3%. The average number of antigen-positive cells was 16.5 cells / 50,000 PMNL. Among them, HCMV patients and asymptomatic HCMV patients averaged 24.5 ± 18.2 / 50,000 PMNL and 12.0 ± 10.6 / 50,000 PMNL, respectively. Fifteen normal individuals (anti-HCMV serum antibody negative) were tested for HCMV antigens simultaneously as a control, and the results were negative. Conclusion The method is simple, rapid and other advantages, and can distinguish between latent infection and active infection, suitable for clinical rapid early diagnosis of HCMV infection and as a guide to exclude the treatment and prognosis of the main means of promotion and application value.