目的: 探讨人巨细胞病毒(HCMV)-脱氧核糖核酸(DNA)定量检测在儿童HCMV感染中的诊断价值。方法: 选取2020年1月-2022年12月我院收治的2 256例疑似HCMV感染患儿,所有疑似患儿均采集晨尿、肺泡灌洗液、抗凝血和促凝血,标本处理完成后采用荧光定量PCR法进行HCMV-DNA检测及采用多重微珠流式免疫荧光法进行血清HCMV-IgM检测;然后比较不同标本类别HCMV-DNA阳性率、不同性别HCMV-DNA阳性率、不同年龄HCMV-DNA阳性率及两种检测方法血液标本的阳性率。结果: 尿液标本内HCMV-DNA阳性率高于肺泡灌洗液、血液标本,且肺泡灌洗液标本内HCMV-DNA阳性率高于血液标本,差异有统计学意义(P＜0.05);男性与女性患儿尿液、肺泡灌洗液及血液HCMV-DNA阳性率相比,差异无统计学意义(P＞0.05);≤28 d患儿肺泡灌洗液标本中HCMV-DNA阳性率高于29 d～1岁、1岁以上患儿,29 d～1岁患儿尿液标本中HCMV-DNA阳性率高于≤28 d、1岁以上患儿,差异有统计学意义(P＜0.05);≤28 d、29 d～1岁、1岁以上患儿血液标本内HCMV-DNA阳性率相比,差异无统计学意义(P＞0.05);HCMV-DNA检测HCMV感染阳性率高于HCMV-IgM检测,差异有统计学意义(P＜0.05)。结论: HCMV-DNA在尿液标本内的检出率最高,对儿童HCMV感染的诊断具有重要价值,且尿液标本采集更为方便,尤其适用于小月龄患儿,值得广泛应用。

Objective: To investigate the diagnostic value of human cytomegalovirus (HCMV) -deoxyribonucleic acid (DNA) quantitative detection in children with HCMV infection. Methods: A total of 2 256 children with suspected HCMV infection admitted to our hospital from January 2020 to December 2022 were selected. All suspected children were collected morning urine, alveolar lavage fluid, anticoagulant and procoagulant. After the completion of sample processing, HCMV-DNA was detected by fluorescence quantitative PCR and serum HCMV-IgM was detected by multiple microsphere flow immunofluorescence. Then the positive rates of HCMV-DNA among different types of specimens, different genders, different ages and the two detection methods were compared. Results: The positive rate of HCMV-DNA in urine was higher than that in alveolar lavage fluid and blood samples, and the positive rate of HCMV-DNA in alveolar lavage fluid samples was higher than that in blood samples, the difference was statistically significant (P＜0.05). There was no significant difference in the positive rate of HCMV-DNA in urine, alveolar lavage fluid and blood between male and female children (P＞0.05). The positive rate of HCMV-DNA in alveolar lavage fluid samples of children aged ≤28 d was higher than that of children aged 29 d to 1 year old and above 1 year old, and the positive rate of HCMV-DNA in urine samples of children aged 29 d to 1 year old was higher than that of children aged≤28 d and above 1 year old, the difference was statistically significant (P＜0.05). There was no significant difference in the positive rate of HCMV-DNA in blood samples of children aged≤28 d, 29 d to 1 year old and over 1 year old (P＞0.05). The positive rate of HCMV infection by HCMV-DNA was higher than that by HCMV-IgM detection, and the difference was statistically significant (P＜0.05). Conclusion: The detection rate of HCMV-DNA in urine samples is the highest, which is of great value for the diagnosis of HCMV infection in children, and the collection of urine samples is more convenient, especially for children with small months of age, and worthy of wide application.