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更昔洛韦治疗幼儿感染人巨细胞病毒的预后评估指标的探讨

李娟   

  1. 天津市儿童医院
  • 收稿日期:2014-04-29 修回日期:2014-05-23 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 李娟

Juan LI   

  1. Department of Gastroenterology and Hepatology, Tianjin Children’s Hospital, Tianjin 300074, China
  • Received:2014-04-29 Revised:2014-05-23 Published:2014-09-15 Online:2014-09-15
  • Contact: Juan LI

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摘要：

【摘要】目的  探讨IE mRNA 和pp67 mRNA 在更昔洛韦治疗后的人巨细胞病毒（HCMV）感染患儿中的表达情况。方法 在接受更昔洛韦治疗前，治疗2 周和停药4 周时检测HCMV 患儿总胆红素（TBIL）、直接胆红素（DBIL）；丙氨酸转氨酶（ALT）、碱性磷酸酶（ALP）及荧光定量PCR 的方法检测HCMV-DNA 拷贝数，IE mRNA 和 pp67 mRNA 的表达采用实时荧光定量PCR 法进行检测。结果 更昔洛韦治疗2 周后，患儿肝功能及血HCMVDNA 均较治疗前降低，停药4 周后TBIL、DBIL、ALT、ALP 及HCMV-DNA 拷贝数均较治疗前显著降低，但是与治疗 2 周比较差异无统计学意义。治疗后2 周，仍有12 例患儿血液中表达pp67 mRNA，表达量显著低于治疗前的pp67 mRNA 表达量，但检测不到患儿表达IE mRNA。停药4 周，pp67 mRNA 阳性表达的患儿数量显著低于治疗2 周的患儿数量，有3 例患儿表达微弱的IE mRNA。2 个基因的mRNA 表达量与治疗2 周比较差异无统计学意义。结论 在更昔洛韦治愈患儿，HCMV-DNA 检测呈现阴性时，应再进行病毒mRNA 检测，对RNA 表达阳性的患儿，应该加强随访与复查，预防病毒复发。

关键词: 巨细胞病毒, 婴儿, 更昔洛韦, IE mRNA, pp67 mRNA, 病毒检测

Abstract:

[Abstract] Objective To study the IE and pp67 mRNA expressions in infants infected human cytomegalovirus
(HCMV) after ganciclovir treatment. Methods  The values of total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were detected in patients with HCMV before treatment, 2 weeks and 4 weeks after treatment. The HCMV-DNA was detected by quantitative PCR. The expression levels of IE mRNA and pp67 mRNA were detected by real-time fluorescent quantitative PCR. Results HCMV DNA stopped copying and the infected in fants were cured following the traditional criterion, however, RNA expression was still tested in part of these infants. Conclusion It should be identified for mRNA expression when HCMV-DNA copies were hardly identified in these infants to prevent from relapse.

Key words: cytomegalovirus, infant, Ganciclovir, IE mRNA, pp67 mRNA, virus identification