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背景:巨细胞病毒活动性感染,尤其是巨细胞病毒肺炎死亡率极高,并易合并细菌、真菌、原虫等感染,直接影响患者的长期存活。因此,寻找一种早期、敏感的巨细胞病毒检测方法显得特别重要。目的:探讨酶联免疫吸附法、免疫组织化学法及流式细胞仪检测在自体外周血造血干细胞移植后巨细胞病毒感染的早期诊断价值。设计、时间及地点:对比观察,病例来自2002/2005南方医科大学南方医院。对象:选择行自体外周血CD34+细胞移植的系统性红斑狼疮(16例)和天疱疮(3例)患者19例,其中男5例,女14例,年龄11~38岁。所有受试者均无糖尿病、哮喘、荨麻疹、湿疹、炎症性肠病和其他风湿病。方法:分别于移植前、移植后3,6,12,24个月进行外周血采集。主要观察指标:应用酶联免疫吸附法、免疫组织化学法及流式细胞仪检测19例接受自体外周血造血干细胞移植患者移植前、移植后3,6,12,24个月时的抗巨细胞病毒抗体及巨细胞病毒抗原。结果:19例患者均进入结果分析。血清学检测显示,全部标本抗巨细胞病毒IgG全部阳性,阳性率100%。抗巨细胞病毒IgM阳性3例,阳性率3.2%。免疫组织化学法检测巨细胞病毒抗原阳性14例,阳性率14.7%。流式细胞仪检测巨细胞病毒抗原阳性13例,阳性率13.7%。4种检测巨细胞病毒感染方法的阳性率存在显著差异(χ2=261.929,P<0.01)。结论:自体外周血造血干细胞移植后存在不同程度的巨细胞病毒感染,临床上开展流式细胞仪检测巨细胞病毒感染具有重要意义。
Background: Cytomegalovirus active infection, especially cytomegalovirus pneumonia, has a high death rate and is susceptible to bacterial, fungal, protozoal infection and other diseases, and has a direct impact on the long-term survival of patients. Therefore, looking for an early, sensitive cytomegalovirus detection method is particularly important. OBJECTIVE: To investigate the early diagnostic value of cytomegalovirus infection after autologous peripheral blood stem cell transplantation by enzyme-linked immunosorbent assay, immunohistochemistry and flow cytometry. DESIGN, TIME AND SETTING: The comparative observation was performed on the Southern Hospital of Southern Medical University from 2002/2005. PARTICIPANTS: Nineteen patients with systemic lupus erythematosus (16 cases) and pemphigus (3 cases) were enrolled in this study. There were 5 males and 14 females, aged from 11 to 38 years old. None of the subjects had diabetes, asthma, urticaria, eczema, inflammatory bowel disease and other rheumatism. Methods: Peripheral blood samples were collected before transplantation and 3,6,12,24 months after transplantation. MAIN OUTCOME MEASURES: Anti-giant cells (MCs) of 19 patients receiving autologous peripheral blood stem cell transplantation before transplantation and at 3, 6, 12 and 24 months after transplantation were detected by enzyme-linked immunosorbent assay, immunohistochemistry and flow cytometry Viral antibodies and cytomegalovirus antigens. Results: All 19 patients entered the result analysis. Serological tests showed that all specimens of anti-cytomegalovirus IgG were all positive, the positive rate of 100%. Anti-cytomegalovirus IgM positive in 3 cases, the positive rate of 3.2%. Immunocytochemical detection of cytomegalovirus antigen positive in 14 cases, the positive rate of 14.7%. Flow cytometry cytomegalovirus antigen positive in 13 cases, the positive rate of 13.7%. There was a significant difference in the positive rates of the four cytomegalovirus (χ2 = 261.929, P <0.01). CONCLUSION: Cytomegalovirus infection exists in some degree after autologous peripheral blood stem cell transplantation. It is of great significance to detect cytomegalovirus infection by flow cytometry in clinic.