联合检测巨细胞病毒感染在原位肝移植术后诊断的应用

目的比较外周血巨细胞病毒（CMV）定量PCR检测,CMV-pp65抗原检测及组织病理学检查对原位肝移植术后CMV感染诊断的价值。方法回顾分析45例肝移植患者临床资料,统计三种检查结果,并结合文献进行讨论。结果三种方法检查均显示,有18例患者发生巨细胞病毒感染,18例均为无临床症状的巨细胞病毒感染。经更昔洛韦治疗,18例全部治愈。结论外周血CMV定量PCR,CMV-pp65抗原检测及组织病理学检查均能作为肝移植术后CMV感染早期诊断的有效手段,CMV定量PCR更敏感,CMV-pp65抗原检测更特异,组织病理学检查则具有创伤性,三者的共同应用能够对CMV感染患者做出早期诊断并且指导治疗。更昔洛韦能够有效治疗CMV感染。

Application of combined detection in diagnosis of cytomegalovirus infection after orthotopic liver transplantation

Objective To compare the diagnostic value of cytomegalovirus（CMV） quantitative PCR,CMV-pp65 antigen test and histopathology in detection of CMV infection after orthotopic liver transplantation.Methods The clinical data of 45 patients who had received liver transplantation from July 2009 to October 2010 in our hospital were retrospectively analyzed along with literature review.Results The three methods indicated that asymptomatic CMV infection was occurred in all 18 patients and all of them were cured after the treatment of Ganciclovir.Conclusion CMV quantitative PCR,CMV-pp65 antigen test and histopathology can be the effective detecting methods for CMV at early stage after orthotopic liver transplantation.CMV quantitative PCR is more sensitive,CMV-pp65 is more specific and the results of histopathology examination is indubitable,although it is a little invasive.The combination of the three methods is effective in the diagnosis and treatment of CMV infection at early stage.Ganciclovir is effective in the treatment of CMV infection.