基于核酸序列的扩增技术在异基因外周血干细胞移植后受者HCMV感染诊断的应用论文.docVIP

　　基于核酸序列的扩增技术在异基因外周血干细胞移植后受者HCMV感染诊断的应用论文 徐鸿绪 刘雅峰 谭恩勋 蔡建涛 【摘要】 本研究探讨基于核酸序列的扩增技术(nucleic acid sequence based amplification，NASBA)检测mRNA对异基因外周血干细胞移植受者术后人类巨细胞病毒(HCMV)感染的诊断价值，并评价该技术对抗病毒治疗的指导意义。以128例移植术后患者为研究对象,采集移植术后外周血352份;利用NASBA检测外周血中HCMV基质外壳蛋白PP67（UL65）mRNA,并与HCMV DNA的结果进行比较。结果表明：352份血标本中，HCMV mRNA阳性105份（29.83%），HCMV DNA阳性183份（51.99%）。128例患者术后有45例发展为HCMV病， HCMV DNA和HCMV mRNA检测诊断HCMV病的敏感性和特异性分别为95.56%(43/45)、93.33%(42/45)和60.24%(50/83)、97.59%(81/83)。两者特异性的比较差异具有显著性（P＜0.05）。结论：HCMV-PP67的NASBA检测方法具有快速、敏感性高和特异性强等优点，可作为快速检测HCMV病的方法用于临床。该法检测结果与移植受者的临床症状相关，故也可用作监视异基因造血干细胞移植受者术后HCMV感染和指导抗病毒治疗的依据。 【关键词】 异基因外周血干细胞移植 人类巨细胞病毒感染 基于核酸序列的扩增技术 Application of Nucleic Acid Sequence-Based Amplification in Detection of Cytomegalovirus mRNA of Recipients after Allogeneic Peripheral Blood Stem Cell Transplantation AbstractThe study RNA detection by nucleic acid sequence-based amplification ( NASBA) technique for human cytomegalovirus (HCMV) infection of the recipients after allo-geneic peripheral blood stem cell transplantation (allo-PBSCT) and to evaluate the clinical significance for guiding antiviral therapy. 352 samples 128 transplant patients after allo-PBSCT. A molecular biological diagnostic technique-NASBA an cytomegalovirus (HCMV) late mRNA encoding the viral structural protein PP67 (UL65) expression in peripheral blood of recipients after allo-PBSCT, and the detected results RNA detection for HCMV disease ens from 84 patients 183 specimens （51.99%）ens (29.83 %) RNA by NASBA. 45 patients RNA for detecting HCMV disease RNA and HCMV DNA（P＜0.05）. It is concluded that the detection of late-mRNA of HCMV by NASBA technique is rapid, sensitive and specific detection for HCMV active infection. The detected result correlates ptoms. It can monitor HCMV infection of allo-PBSCT transplanted recipients and provide indication to antiviral therapy. Key cell transplantation； human cytomegalovirus infection; nucleic acid sequence-based amplification 异基因外周血干细胞移植（allogeneic peripheral bloo