孕妇尿液人巨细胞病毒DNA筛查及血液HCMV抗体测定的对照研究

目的对于孕妇尿液进行HCMV—DNA筛查,减少和有效地避免胎儿及新生儿的HCMV感染。HCMV．DNA筛查同时进行HCMV抗体检测,明确诊断HCMV感染的灵敏、准确方法。方法应用荧光定量PCR（FQ．PCR）方法进行尿液HCMV-DNA测定。血液HCMV IgM、IgG抗体检测应用酶联免疫（ELISA）方法。结果筛查6568例孕妇尿HCMV．DNA,阳性273例,阳性率为4．2％。孕妇在12—20周者,阳性率为10．3％;孕妇在21～30周者,阳性率为33．3％;孕妇在31～39周者,阳性率为56．4％。在273例尿液HCMV—DNA阳性者中,56例同时进行血液HCMV IgM、IgG抗体检测,Igi抗体阳性者2例,IgG抗体阳性者22例。结论在孕妇HCMV感染的筛查与诊断中FQ．PCR是灵敏准确的方法。孕妇中HCMV—DNA筛查是保证母婴健康,提高人口素质的保障。     

孕中期巨细胞病毒宫内感染与血Free-β-HCG水平的相关性研究

目的:通过检测孕中期妇女人巨细胞病毒(HCMV)活动性感染、宫内感染以及血Free-β-HCG水平,分析血Free-β-HCG水平与HCMV宫内感染的相关性,初步探讨其可能影响机制.方法:通过酶免法测孕妇血HCMV-IgM和定荧光定量PCR对孕中期妇女血清和羊水中HCMV-DNA的检测以及DILFIA法(时间分辨免疫荧光法)定量检测孕中期妊娠妇女血Free-β-HCG的含量,研究HCMV感染状况与Free-β-HCG之间的相关性,探讨HCMV对母血Free-β-HCG水平的影响.结果:718例样本中共检出HCMV-IgM阳性和(或)HCMV-DNA阳性者共43例并进一步行产前诊断羊水HCMV-DNA阳性14例.孕中期HCMV活动性感染率为5.98％,HCMV宫内感染率为2.22％.孕中期感染组Free-β-HCG含量:7.32± 2.25 ng/ml,非感染组:8.47± 3.17 ng/ml,对照组:10.10± 3.67 ng/ml.结论:HCMV宫内感染组比非感染组孕中期外周血Free-β-hcG的测定水平降低,两者结果之间的差异具有统计学意义.HCMV可通过损伤胎盘绒毛滋养层细胞,使Free-β-hcG的分泌减少.     

实验室2种检测小儿巨细胞病毒方法的比较

比较胶体金法和实时定量PCR法对小儿巨细胞病毒IgM抗体水平检测的敏感性及准确率。收集临床上243例小儿的血液标本,分别采用实时荧光定量PCR法和胶体金法检测这243例患者外周血巨细胞病毒IgM抗体水平,并对这2种检测方法的阳性率和敏感性进行比较分析。实时荧光定量PCR法阳性率为11.93%,胶体金法为6.58%,2者差异有统计学意义(P<0.01)。在HCMV-DNA检测阳性患者中,IgM抗体阳性组HCMV-DNA拷贝数显著高于阴性组(P<0.01),比较这2种检测方法的敏感性,实时荧光定量PCR法的敏感性为72.5%,胶体金法的敏感性为40%,两者差距有统计学意义(P<0.01)。实时荧光定量PCR法与胶体金法相比,对巨细胞病毒IgM抗体检测具有较高的敏感性和准确率,值得临床推广应用。     

HCMV-DNA定量检测和HCMV-IgG抗体AI检测在儿童HCMV感染诊断中的临床价值

摘要 目的：探讨人巨细胞病毒（HCMV）-DNA定量检测和HCMV-免疫球蛋白G（IgG）抗体亲和力指数（AI）检测在儿童HCMV感染诊断中的临床价值。方法：收集高度疑似HCMV活动性感染患儿血清样本103例作为研究组,健康体检儿童血清样本94例作为对照组。分析HCMV-DNA定量检测结果和HCMV-IgG抗体AI检测结果,并比较不同年龄、不同性别患儿HCMV-DNA阳性结果检出率和低HCMV-IgG抗体AI检出情况。结果：研究组血清HCMV-DNA阳性率为33.01%（34/103）,对照组血清HCMV-DNA均为阴性,研究组血清HCMV-DNA阳性率明显高于对照组,差异有统计学意义（P<0.05）。研究组血清低HCMV-IgG抗体AI检出率为13.59%（14/103）,对照组未检出低HCMV-IgG抗体AI,研究组血清低HCMV-IgG抗体AI检出率高于对照组,差异有统计学意义（P<0.05）。研究组不同性别之间患儿血清的HCMV-DNA阳性率、低HCMV-IgG抗体AI检测结果均无统计学差异（P>0.05）。研究组年龄1～5岁患儿血清HCMV-DNA阳性率明显低于年龄1 d～<6个月和年龄6个月～<1岁患儿（P<0.05）。三个年龄段患儿的血清低HCMV-IgG抗体AI检测结果均无统计学差异（P>0.05）。结论：1岁以下儿童更易受到HCMV感染,HCMV-DNA定量检测和HCMV-IgG抗体AI检测结果可以为临床早期诊断和治疗HCMV感染提供有效依据。     

血液病患者的巨细胞病毒感染

用间接酶联免疫吸附实验(ELISA)对新近诊断的179例血液病患者血清巨细胞病毒(HCMV)IgM和IgA抗体进行了检测。阳性率分别为11,17％11,73％,明显高于对照人群(4,76％和3,97％),提示血液病患者由于免疫功能下降,易于发生HCMV活动性感染。     

人巨细胞病毒pp65特异性抗体测定在原发感染诊断中的应用

目的 通过测定患者单份血清人巨细胞病毒(HCMV)pp65特异性IgM抗体和IgG亲和指数(AI),建立HCMV原发感染的临床判断标准.方法 从临床收集40份患儿血清和尿标本,以本室自制的pp65为抗原,运用间接酶联免疫吸附试验(ELISA)检测血清标本中HCMV pp65特异性IgM抗体;同时通过尿素变性实验,以6M尿素作为温和蛋白变性剂,测定HCMVpp65 IgG AI.尿标本常规处理后接种人胚成纤维(HF)细胞进行病毒分离,观察HCMV特异性细胞病变效应(CPE),聚合酶链反应(PCR)试验检测细胞培养物UL83基因,间接免疫荧光试验检测细胞玻片HCMV抗原.并将病毒分离结果 同血清学方法 进行比较.结果 40例标本中,IgM阳性13例,IgG阳性30例,其中,仅IgM阳性4例,病毒分离结果 亦为阳性,可诊断为原发感染;30例IgG阳性标本中,2种抗体均为阳性9例(A组),其中,5例AI＜50﹪,病毒分离结果 均为阳性,判断为原发感染;1例AI在50﹪与60﹪之间,为可疑原发感染,需要进一步鉴定;3例AI＞60﹪,判断为继发感染.IgG阳性21例(B组),其中仅3例(14.29﹪)AI＜50﹪,但病毒分离结果 为阴性,提示患者不久前曾发生HCMV原发感染,特异性IgM抗体已经转阴,病毒进入潜伏状态;余18例患者AI均＞60﹪,判断为继发感染;2种抗体均为阴性的标本有6例,病毒分离结果 亦为阴性,说明患者未被感染.统计学分析,A组与B组之间差异有统计学意义(P＜0.05).血清学方法 与病毒分离比较,一致率为75.49﹪,该方法 灵敏度为100﹪,特异度为87.10﹪,准确度为90.00﹪.结论 以HCMV pp65重组蛋白为抗原检测特异性抗体以及相应IgG AI的ELISA,可快速诊断HCMV原发感染和继发感染;该方法 具有高度特异性与敏感性,操作简便,重复性好,具有良好的临床应用前景.     

抗HCMV Pp65蛋白单克隆抗体的制备及性质研究

人类巨细胞病毒（Human cytomegalovirus,HCMV）是一种机会性感染疱疹病毒,在人群中感染比较常见,但在免疫缺陷个体与新生儿中可引起严重的疾病。HCMV Pp65是HCMV活动感染的主要标志,也是临床检验检测HCMV感染的重要靶标。为研发抗HCMV Pp65蛋白单克隆抗体作为临床免疫检测HCMV感染的关键原料,本研究采用重组表达的HCMV Pp65蛋白免疫BALB/c小鼠,将免疫小鼠淋巴结细胞与sp2/0细胞融合,采用间接ELISA法筛选阳性克隆与效价测定,再用Western blotting进行抗体特异性鉴定,最后用免疫捕获PCR和免疫荧光法评价其应用前景。最终获得了1株能稳定分泌高效价的抗HCMV Pp65单克隆抗体的杂交瘤细胞株,命名为8D6。Western blotting及间接ELISA检测其效价分别达1∶4 000和1∶105;细胞免疫荧光与免疫捕获PCR实验结果说明,该杂交瘤细胞株分泌的单克隆抗体具有良好的亲和力和特异性,具有作为外周血细胞免疫荧光细胞化学和免疫捕获PCR检测HCMV临床感染的关键原料,也可作为双抗体夹心法检测HCMV临床感染的关键原料,为建立HCMV感染快速灵敏的临床诊断试剂打下了重要的基础。     

新生儿高胆红素血症与先天性巨细胞病毒感染的相关性研究

目的:探讨新生儿高胆红素血症与巨细胞病毒(HCMV)感染的相关性及临床意义。方法:对170例疑为高胆红素血症新生儿血清标本分别检测HCMV的IgG和IgM及血清总胆红素(TBIL)。排除高胆红素血症新生儿血清标本100例为正常对照。结果:高胆红素血症患者血清HCMV-IgG、IgM阳性率高于正常对照组,两者比较有统计学意义。结论:巨细胞病毒感染与新生儿高胆红素血症相关性大,是引起高胆红素血症的主要病原之一。     

肿瘤患者化疗后人巨细胞病毒活动性感染检测

探讨肿瘤患者化疗后人巨细胞病毒感染检测方法的应用价值。使用免疫组化法、酶联免疫吸附试验检测IgG/M抗体,以及实时荧光定量(FQ-PCR)检测HCMV DNA。47份全血标本中抗原阳性率为48.9%,平均抗原阳性细胞数7.9±8.1(1-65)/5×104WBC,HCMV DNA阳性率19.1%(10/47),HCMV DNA含量均值为6.320×105copies,白细胞HCMV-DNA阳性率51%(25/47),HCMV DNA含量均值为3.830×107 copies,HCMV pp65抗原阳性率为48.9%(23/47),IgG抗体均阳性,IgM抗体阳性率为23.4%(12/47),以PP65抗原阳性为对照,IgM抗体检测的敏感率仅为49.3%。在连续动态检测HCMV多种指标时,结合DNA及抗原动态检测具有更高临床应用价值。     

单克隆抗体间接免疫荧光法检测巨细胞病毒分离培养中的抗原

应用抗巨细胞病毒(HCMV)蛋白抗原(分子量为20千道尔顿)的单克隆抗体(McAb-20k)和HCMV IgG特异性阳性血清以间接免疫荧光试验检测28例器官移植病人尿标本接种人胚肺细胞后的HCMV感染情况,结果前法于接种后48小时检测到HCMV阳性病人9例,后者于接种6天检测到阳性病人11例。与病毒分离结果相比较,两法的敏感性分别为81.8％和90.9％,特异性相应为100％和94.12％,符合率均为92.9％,比病毒分离提前数天至数周作出诊断,重复性良好。因此,抗HCMV蛋白抗原的单克隆抗体间接免疫荧光法是一种有效的、早期快速而又敏感特异的诊断方法,操作简便,既使没有单抗,可用HCMV IgG阳性血清代替,也可取得较好效果,值得在一般实验室推广应用。     

Cytomegalovirus and atherosclerosis

Finding that an avian herpesvirus can cause atherosclerosis in chickens prompted studies of human herpesviruses in human atherosclerosis. Antigens and nucleic acid sequences of cytomegalovirus (CMV), a widespread member of the herpesvirus family, were found in arterial lesions in human atherosclerosis, but infectious virus has not been observed. In atherosclerosis patients, high levels of CMV antibodies are present, suggesting the presence of virus that had been activated from a latent state. Atherosclerosis also develops in immunesuppressed heart transplant patients infected with CMV. The properties of CMV are consistent with its involvement at several levels of the atherogenic process. If this concept is correct, immunization with a CMV vaccine should prevent CMV infection and atherosclerosis.     

Cytomegalovirus and Epstein-Barr Virus in Breast Cancer

Findings of polymerase chain reaction (PCR) studies of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) and breast cancer vary, making it difficult to determine whether either, both, or neither virus is causally associated with breast cancer. We investigated CMV and EBV in paired samples of breast cancer and normal breast tissue from 70 women using quantitative PCR. A serum sample from each woman was tested for CMV and EBV IgG. To place our results in context, we reviewed the existing literature and performed a meta-analysis of our results together with previous PCR studies of EBV, CMV, and breast cancer. Of the serology samples, 67 of 70 (96%) were EBV IgG positive and 49 of 70 (70%) were CMV IgG positive. QPCR detected EBV in 24 (34%) of the tumour and 9 (13%) of the paired normal specimens and CMV in 0 (0%) of the tumour and 2 (3%) of the paired normal specimens. Our findings, together with earlier results summarised in the meta-analysis, suggest several possibilities: variable findings may be due to limitations of molecular analyses; ‘hit and run’ oncogenesis may lead to inconsistent results; one or both viruses has a role at a later stage in breast cancer development; infection with multiple viruses increases breast cancer risk; or neither virus has a role. Future studies should focus on ways to investigate these possibilities, and should include comparisons of breast cancer tissue samples with appropriate normal tissue samples.     

人巨细胞病毒与肿瘤研究进展

人巨细胞病毒（HCMV）是目前已知最大的β疱疹病毒。HCMV感染具有持续性和潜在性,感染率在全世界范围内都很高,并随着年龄的增长而升高,女性感染率高于男性,其主要的传播途径有垂直传播和性传播等。近年来的研究显示在人类胶质瘤、结直肠癌、乳腺癌和前列腺癌及小细胞型肝癌等多种类型的肿瘤组织中都存在HCMV感染和病毒基因表达,并与肿瘤的恶性程度有相关性,这提示HCMV可能在人类某些类型肿瘤的形成和发展过程中扮演重要角色,有可能成为一种新的人类肿瘤相关病毒。HCMV基因产物可通过多种细胞信号通路抑制细胞凋亡、促进细胞增殖、侵袭、转移和血管生成,并形成独特的免疫逃避机制对抗机体免疫反应。深入研究HCMV与肿瘤的病因学关系及其作用机制,可为肿瘤的临床防治提供新思路。     

Cytomegalovirus infection in melanoma patients

The occurrence of active cytomegalovirus (CMV) infection in 30 patients with skin melanoma, aged 18-76 years, was studied with the enzyme immunoassay, the direct immunofluorescence test and the polymerase chain reaction. The patients were divided into two groups: group I consisted of 20 patients examined in a month after radical surgical treatment, group II consisted of 10 patients at the stage of the process generalization. For comparison, group III was formed consisting of 89 patients with diagnosed secondary immunodeficiency and clinical manifestations of CMV infection. The control group included 80 donors. The study showed that in group II the occurrence of active CMV infection was 4 times higher than in group I and practically coincided with the results registered in group III. In the evaluation of the immune status of the members of group II the most profound changes were revealed in T-cell mediated immunity and in phagocytic immunity; the adequate production of tumor necrosis factor alpha and interleukin 1beta was absent, which created prerequisites for the activation of CMV and the aggravation of the prognosis.     

Cytomegalovirus infection in Omsk region

Epidemiologic studies of prevalence of cytomegalovirus infection (CMVI) in Omsk region during a period of 15 years showed 1.6-fold increase of population seropositivity to CMV with rate of increase +2.94. In recent years antibodies to CMV were detected in 90.3 - 94.8% of cases. Diagnostics of innate and acquired CMVI was improved. Feasibility of detection of infectious process activity during complex use of new laboratory methods (IgA detection, assessment of IgG avidity, IgG to individual antigens in immunoblotting as well as detection of DNA and "early phase" viral ptoteins) was demonstrated. High rates of infection in population determine the necessity of revision of strategy for examination of children and adults, including screening of pregnant woman, on this infection.