Clinical Analysis on the Detection of Human Cytomegalovirus DNA in 2403 Samples of Different Types
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摘要:
目的 探讨孕妇和婴儿不同类型标本中人巨细胞病毒（HCMV）DNA的检出情况，并进行临床分析。 方法 2021年5月至2021年10月收集到在昆明市妇幼保健院检验科采用荧光定量PCR法进行HCMV-DNA检测的临床标本共2 403份，对不同标本来源人群、不同类型标本的HCMV-DNA检出率进行回顾性分析。 结果 2 403份不同类型的标本中，乳汁的HCMV-DNA检出率为31.70%，尿液为0.85%，血清为0%。2个年龄段（0～28 d和28 d至６个月）母亲乳汁、尿液标本的检出率随婴儿年龄增加而增高，且差异均有统计学意义（P < 0.001）。同时进行了尿液及其母亲乳汁HCMV-DNA检测的221例婴儿中，检出率：乳汁22.62%，尿液0.45%，乳汁的检出率高于尿液。当母亲乳汁标本HCMV-DNA 阴性，患儿自身尿液标本为阳性的占0.58%，阴性占99.42%；母亲乳汁标本HCMV-DNA 阳性时，患儿自身尿液标本全为阴性。 结论 孕妇及其婴儿的各类标本中，乳汁标本的HCMV-DNA检出率明显高于其他类型标本，对于疑似HCMV感染的孕妇或婴儿，建议首先采集母亲乳汁标本进行检测。然而母亲乳汁中是否检出HCMV-DNA也并不能完全反映婴儿体液标本的检出情况。随着发育，婴儿尿液检出率会增高，需要进一步采集不同时段、不同时期婴儿体液标本进行检测和综合分析。 Abstract:Objective To analyze the detection of human cytomegalovirus （HCMV） DNA in different types of samples from pregnant women and infants. Methods From May 2021 to October, a total of 2403 clinical samples were collected. Fluorescence quantitative PCR to test the HCMV-DNA, and we analyzed positive rate of HCMV-DNA in different samples sources and types retrospectively. Results Among different types of samples, the positive rate of HCMV-DNA in maternal milk was 31.70%, and that in urine was 0.85%. The positive rate of maternal milk and urine samples increased with the increase of age, and the difference was statistically significant （P < 0.001）. Among 221 urine samples from infants as well as their maternal milk samples, the positive rate of maternal milk samples was higher than that of urine or serum. When the maternal milk samples were negative, 0.58% of the children’ s urine samples were positive; When the maternal milk samples were positive, the children’ s urine were negative. Conclusions The positive rate of HCMV-DNA in maternal milk samples is significantly higher than that in other types of samples. Therefore, for pregnant women or infants with suspected infected HCMV, it’ s recommended to collect milk samples for the test. However, HCMV-DNA detected in maternal milk can’ t fully reflect the detection of infant body fluid samples. As age goes on, the positive rate of infant urine will increase. It is necessary to collect fluid samples at different periods for the test, and analyze comprehensively the test results. -
表 1 尿液、乳汁和血清标本HCMV-DNA检测结果比较（n）
Table 1. Comparison of HCMV-DNA test results in urine，maternal milk and serum samples （n）
标本类型 阴性例数 阳性例数 合计 阳性率（%） 尿液 1 995 17 2 012 0.85 乳汁 265 123 388 31.70 血 3 0 3 0 合计 2 263 140 2 403 5.83 
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表 2 不同年龄段婴儿、不同类型标本HCMV-DNA检出率（n）
Table 2. Positive rate of HCMV-DNA in different ages of infants and different types of specimens （n）
标本类型 新生儿（< 28 d） 28 d至6个月婴儿 χ2 P 标本例数 检出例数 检出率（%） 标本例数 检出例数 检出率（%） 尿液 1 969 14 0.71 43 3 6.98 19.72 < 0.001* 母亲乳汁 342 86 25.15 30 26 86.67 49.61 < 0.001* 血清 0 0 0.00 3 0 0.00 *P < 0.05。
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表 3 221例婴儿尿液标本与其母亲乳汁标本HCMV-DNA检测结果分布（n）
Table 3. HCMV-DNA test results of 221 urine samples from infants as well as their maternal milk samples （n）
婴儿尿液标本HCMV-DNA 母亲乳汁标本HCMV-DNA 阴性例数 阳性例数 阴性例数 170 50 阳性例数 1 0 合计 171 50
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表 4 17例HCMV感染患儿的年龄、性别和喂养史（n）
Table 4. Age，sex and feeding history of 17 children with HCMV infection （n）
一般情况 n 性别 男 5 女 12 年龄 ≤14 d 12 ～3个月 2 ～6个月 3 喂养史 母乳喂养 13 人工喂养 1 混合喂养 3
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