巨细胞病毒抗原血症对宫内巨细胞病毒感染的临床重要性。

Clinical importance of cytomegalovirus antigenemia for intrauterine cytomegalovirus infection.

作者信息

Kaneko Masatoki, Sameshima Hiroshi, Ikenoue Tsuyomu, Kusumoto Kazumi, Minematsu Toshio

机构信息

Perinatal Center and Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

出版信息

Pediatr Int. 2009 Feb;51(1):1-4. doi: 10.1111/j.1442-200X.2008.02651.x.

DOI:10.1111/j.1442-200X.2008.02651.x

PMID:19371269

Abstract

BACKGROUND

Little is known about the clinical importance of cytomegalovirus (CMV) antigenemia for intrauterine-CMV-infected newborns. The aims of the present study were to evaluate the diagnostic accuracy of CMV antigenemia during the neonatal period and its association with clinical manifestations.

METHODS

CMV antigenemia was analyzed using neonatal blood from 25 patients suspected of having intrauterine infection because of abnormal clinical manifestations in the mother, fetus, and newborn. Neonatal urine samples were collected for diagnosis of intrauterine infection. The diagnostic accuracy of the antigenemia analysis was evaluated by comparing it with the results of urinary CMV analyses. The clinical manifestations of antigenemia-positive and -negative infected newborns were compared in the infected newborns.

RESULTS

Fifteen newborns were congenitally infected and 10 were uninfected as diagnosed on virus isolation from neonatal urine. Six of 15 infected newborns were positive for CMV antigenemia. CMV antigenemia had a positive predictive value of 100%, a negative predictive value of 52.6%, a sensitivity of 40%, and a specificity of 100%. CMV retinitis and pneumonitis were more prevalent among antigenemia-positive newborns (4/6) than antigenemia-negative newborns (0/9; P < 0.05).

CONCLUSIONS

Antigenemia was significantly associated with retinitis and pneumonia, but it was not sensitive enough to diagnose intrauterine CMV infection.

摘要

背景

关于巨细胞病毒（CMV）抗原血症对宫内CMV感染新生儿的临床重要性知之甚少。本研究的目的是评估新生儿期CMV抗原血症的诊断准确性及其与临床表现的关联。

方法

使用来自25例因母亲、胎儿和新生儿临床表现异常而怀疑有宫内感染的患者的新生儿血液分析CMV抗原血症。收集新生儿尿液样本用于诊断宫内感染。通过将抗原血症分析结果与尿CMV分析结果进行比较来评估抗原血症分析的诊断准确性。对感染新生儿中抗原血症阳性和阴性的感染新生儿的临床表现进行比较。

结果

根据从新生儿尿液中分离病毒诊断，15例新生儿为先天性感染，10例未感染。15例感染新生儿中有6例CMV抗原血症呈阳性。CMV抗原血症的阳性预测值为100%，阴性预测值为52.6%，敏感性为40%，特异性为100%。CMV视网膜炎和肺炎在抗原血症阳性的新生儿（4/6）中比抗原血症阴性的新生儿（0/9）更常见（P<0.05）。