巨细胞病毒感染与炎症性肠病相关性研究

摘要

Objective:To observe the correlation between HCMV infection and inflammatory bowel disease from the gene level of HCM..Methods:A cross-sectional prospective study was conducted between September 2007 and June 2010 in a cohort of 76 patients diagnosed with IBD (52 with ulcerative colitis and 24 with Crohn' s disease) in two adult gastrointestinal.Prevalence of CMV infection was estimated by pathologic studies in intestinal sections and by molecular assays in blood and intestinal tissue samples and compared with a control group of 40 individuals with noninflammatory disease.Results:Immunohistochemical staining showed CMV antigen in 9 IBD patients (7 with ulcerative colitis;8 with severe disease),whereas CMV antigen was not detected in any of the controls.CMV genome in both the intestinal tissue and blood was found by polymerase chain reaction in 23 (30.3%) of the total IBD patients,in 16 (30.8%) of those with ulcerative colitis,and in 7 (25.9%) of those with Crohn' s disease.In addition,five (6.6%) IBD patients (2 with ulcerative colitis and 3 with Crohn' s disease) had detectable CMV genome in their intestinal samples but not in their blood.In the control group,five (12.5%) individuals had detectable CMV genome in their blood,but only one (2.5%) in his intestine.Conclusion:Patients with ulcerative colitis had more often detectable CMV genome in their blood as well as in their intestinal tissue samples as compared with controls (P= 0.034 and P<0.0001,respectively).However,patients with Crohn' s disease had more often detectable CMV genome only in their intestinal tissue samples as compared with controls (P=0.002).Detection of CMV genome in blood or intestinal tissue was significantly associated with short duration of IBD (P=0.004 and 0.03,respectively) but not with age,sex,severity of the disease,activity at colonoscopy,pancolitis,admi nistration of a specific treatment,and surgery.In this cross-sectional prospective study,detection of CMV genome or antigen in the intestine was commonly associated with IBD.%目的:从CMV基因水平观察巨细胞病毒(cytomegalovirus,CMV)感染与炎症性肠病(infl ammatory bowel disease,IBD)的相关性.方法:我们从2007～2010年,对76例溃疡性结肠炎(ulcerative colitis,UC)52例,克罗恩病(Crohn's disease,CD)24例的成人患者进行研究,研究CMV感染者肠道病理标本及其血液的分子水平、肠道组织标本免疫组化,以40例非炎症性肠病者作为对照组.结果:免疫组化着色显示CMV抗原阳性9例(7例是UC、8例是严重IBD病例),对照组CMV抗原均阴性.PCR-CMV基因在全部IBD肠组织标本、血液中均阳性有23(30.3%)例,16(30.8%)例为UC,7(25.9%)例为CD.此外,5(6.6%)例IBD中(2例UC,3例CD)在肠道组织检测到CMV基因,而在血液中未检测到.在对照组,5(12.5%)例血液中检测到CMV基因,仅1例(2.5%)在肠道组织检测到CMV基因.结论:UC与对照组相比,更易检测到CMV(在血液和肠道组织样本)(P=0.034和P<0.0001),而CD患者与对照组相比,更易在肠道组织标本检测CMV基因(P=0.002),在血液或肠道检测到CMV基因与IBD持续时间明显相关(P=0.004和0.03),但与年龄、性别、疾病的严重程度、结肠镜下的活动性、全结肠炎、需要特殊治疗和外科手术无关.在本研究中,检测到肠道CMV基因或抗原常与IBD有关.