Reina Prieto J, Bestard Palmer X, Saurina Gomila J, Gascó Company J, Fernández-Baca Gutiérrez del Alamo V, Munar Roca M
Unidad de Virología, Hospital Universitario Son Dureta (UIB), Palma de Mallorca.
Rev Clin Esp. 1998 Jan;198(1):3-6.
To prospectively and comparatively study the usefulness of urine (viruria) and blood (antigenemia pp65 and culture) (viremia) for the diagnosis of cytomegalovirus (CMV) infection in renal transplant (RT) recipients.
All RT recipients at our hospital were studied from January 1995 to December 1996. After decontamination, urine specimens were inoculated into two MRC-5 cell line vials. Polymorphonuclear cells were extracted from peripheral blood by sedimentation in saline dextran and were used for antigenemia pp65 test and for culture in shell-vial.
A total of 1,335 specimens from 43 patients were studied. CMV was recovered from 110 out of the 913 (12%) urine specimens and from 101 out of the 422 (23.9%) blood specimens (antigenemia and/or viremia). CMV detection was first obtained by a positive blood test in 23 patients (88.4%), whereas the urine specimen was the first positive test in only three (11.6%) patients (p = 0.0001). A positive result in blood preceded a positive result in urine by a mean of 10.3 days (range: 2-73 days). Antigenemia and viremia were simultaneously positive in 61.5% of patients. In three patients a positive antigenemia preceded viremia by 14 days. In seven patients (26.9%) only the shell-vial culture was positive. Culture preceded antigenemia by a mean of 7.6 days. In the 26 patients, the time elapsed until the first positive blood specimen for CMV was 37.3 days (range: 11-88 days).
According to the results obtained we believe that blood (antigenemia pp65 and/or viremia) should be considered as the only really useful specimen for the diagnosis of infection/disease caused by CMV in RT recipients. The urine specimen lacks a diagnostic and clinical usefulness and therefore should not be used in these patients.
前瞻性比较研究尿液（病毒尿）和血液（pp65抗原血症及培养）（病毒血症）在肾移植（RT）受者巨细胞病毒（CMV）感染诊断中的作用。
对我院1995年1月至1996年12月期间的所有肾移植受者进行研究。尿液标本经去污处理后接种于两个MRC - 5细胞系小瓶中。通过在生理盐水葡聚糖中沉降从外周血中提取多形核细胞，用于pp65抗原血症检测及在空斑试验管中培养。
共研究了43例患者的1335份标本。在913份尿液标本中有110份（12%）检测到CMV，在422份血液标本（抗原血症和/或病毒血症）中有101份（23.9%）检测到CMV。23例患者（88.4%）首次通过血液检测呈阳性确诊CMV，而仅3例患者（11.6%）首次尿液检测呈阳性（p = 0.0001）。血液检测呈阳性结果比尿液检测呈阳性结果平均提前10.3天（范围：2 - 73天）。61.5%的患者抗原血症和病毒血症同时呈阳性。3例患者抗原血症呈阳性比病毒血症早14天。7例患者（26.9%）仅空斑试验管培养呈阳性。培养比抗原血症平均早7.6天。26例患者中，首次CMV血液标本呈阳性的时间为37.3天（范围：11 - 88天）。
根据所获结果，我们认为血液（pp65抗原血症和/或病毒血症）应被视为肾移植受者CMV感染/疾病诊断中唯一真正有用的标本。尿液标本缺乏诊断和临床应用价值，因此不应在这些患者中使用。
