不同時段尿標本檢測巨細胞病毒在小兒人巨細胞病毒感染中的應用

黃斌 劉素云 萬麗佳 劉明 吳小秧 羅勤

[摘要]目的 對熒光定量PCR法在人巨細胞病毒感染患兒不同時段尿標本檢測巨細胞病毒中的應用效果進行探討。方法 選取2015年9月～2017年2月我院兒科收治的30例人巨細胞病毒感染患兒，所有患兒分別于清晨采集晨尿作為晨尿組，于其他時段采集尿液標本作為隨機時段組，應用實時熒光定量PCR技術對不同時段尿標本人巨細胞病毒DNA水平進行檢查，對比兩組陽性檢出率。結果 晨尿組，27例檢出人巨細胞病毒陽性，檢出率為90.00%，隨機時段組，20例檢出人巨細胞病毒陽性，檢出率66.67%，晨尿組明顯高于隨機時段組，差異有統計學意義（P<0.05）。結論 對人巨細胞病毒感染患兒應用實時熒光定量PCR技術檢測巨細胞病毒，采集患兒晨尿作為檢測標本，陽性檢出率較高，可有效降低漏診情況，在臨床中值得推廣應用。

[關鍵詞]人巨細胞病毒；小兒；實時熒光定量PCR；不同時段

[中圖分類號] R446.1 [文獻標識碼] A [文章編號] 1674-4721（2018）4（c）-0119-03

Detection of cytomegalovirus in children with cytomegalovirus infection by urine samples at different time intervals

HUANG Bin LIU Su-yun WAN Li-jia LIU Ming WU Xiao-yang LUO Qin

Department of Pediatrics，People′s Hospital of Pingxiang City，Jiangxi Province，Pingxiang 337000，China

[Abstract]Objective To investigate the effect of fluorescent quantitative PCR in detection of cytomegalovirus （HCMV） in urine samples of children with HCMV infection at different time intervals.Methods A total of 30 cases of infection in our hospital from September 2015 to February 2017 in Department of Pediatrics of infected children，for all children were collected in the morning urine as morning urine group，collecting urine specimens as random specimens from other time periods，the application of real-time fluorescence quantitative PCR technology in different periods of urine HCMV DNA level standard for examination，the positive detection rate was compared between the two groups.Results The results showed that morning urine group，27 cases were detected HCMV positive，the detection rate of 90.00%，random time urine group，20 cases were detected HCMV positive，the detection rate of 66.67%，compared the two groups，morning urine group was significantly higher than that of random time group，the difference was statistically significant （P<0.05）.Conclusion The detection of HCMV real-time fluorescent quantitative PCR in children with infection of HCMV in children，collection of morning urine samples for testing，the positive rate is high，effectively reduce the misdiagnosis，it is worth in clinical application.

[Key words]Human cytomegalovirus；Children；Real-time quantitative PCR；Different periods

巨細胞病毒感染是由人巨細胞病毒（human cytom-egalovirus，HCMV）引起的人類感染性疾病。HCMV一旦侵入體內，將長期或終身存在體內，在絕大多數免疫正常個體，常成無癥狀感染，但在免疫抑制個體，新生兒及嬰幼兒可出現明顯病癥，表現為肝炎、肺炎、腦膜腦炎、智力低下和先天性耳聾等。HCMV可從宿主尿液、血液及呼吸道分泌物等多個部位排出，國內外已廣泛進行血尿痰等不同標本的檢測[1-2]，尿液標本因其陽性率較高[3]、無創傷，易為患兒及家屬所接受。目前國內外已有晨尿標本檢測HCMV-DNA水平的相關報道[4]，但新生兒及嬰幼兒因其排尿控制較困難，有時需采集其他時段隨機尿標本。本研究通過對不同時段尿應用實時熒光定量PCR技術檢測HCMV-DNA水平，比較晨尿與隨機時段尿的HCMV陽性檢出率，現報道如下。……