宫内和围生期巨细胞病毒感染临床特点及实验室检查比较
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摘要
目的探讨新生儿巨细胞病毒(human cytomegalovirus, HCMV)宫内及围生期感染的临床表现及实验室检查结果的差异。方法荧光定量PCR法检测2015年1月-2017年12月湖北省妇幼保健院新生儿科就诊疑似患儿尿液巨细胞病毒DNA(HCMV-DNA),同时进行血常规、肝功能、X胸片、肝胆、颅内B超等辅助检查,分析宫内和围生期巨细胞病毒感染临床表现及实验室检查数据差异。结果 2015年1月-2017年12月共检测患儿6 457例,HCMV阳性病例91例,感染率1.41%;宫内和围生期巨细胞病毒感染患儿分别有49和42例,其HCMV-DNA拷贝数对数值分别为(5.06±1.53)、(4.29±1.32),差异有统计学意义(t=2.54,P=0.013);宫内和围生期巨细胞病毒感染患儿神经系统体征发生率(14.3%vs.0%,χ~2=4.644,P=0.031)及γ-谷氨酰转肽酶(γ-glutamyltransferase, GGT)(61.2%vs.31.0%,χ~2=8.315,P=0.004)、红细胞(red blood cell, RBC)(8.2%vs.26.2%,χ~2=5.339,P=0.043)和红细胞压积(hematocrit,Hct)(10.2%vs.33.3%,χ~2=7.324,P=0.007)异常率差异有统计学意义。结论新生儿巨细胞病毒宫内感染神经系统体征、肝胆梗阻较围生期感染发生率高,危害更大;围生期感染呼吸及血液系统症状较宫内感染更为多见。
引文
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[9] Min CY, Song JY, Jeong SJ. Characteristics and prognosis of hepatic cytomegalovirus infection in children: 10 years of experience at a university hospital in Korea [J]. Korean J Pediatr, 2017,60(8):261-265.
[2] van Zuylen WJ, Hamilton ST, Naing Z, et al. Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention[J].Obstet Med, 2014, 7(4):140-146.
[3] 李东明,张硕,陶春凤,等.南宁地区孕妇与新生儿TORCH检测结果分析[J].中华全科医学,2016,14(1):87-89.
[4] Mamuye Y, Niqatu B, Bekele D, et al. Maternal and congenital cytomegalovirus infection and zero rubella IgM prevalence in newborns in St. Paul’s Hospital Millennium Medical College [J]. BMC Res Notes, 2016, 9(1):476.
[5] Coclite E, Di Natale C, Nigro G. Congenital and perinatal cytomegalovirus lung infection[J].J Matern Fetal Neonatal Med, 2013, 26(17):1671-1675.
[6] 胡洪波,陈坤,彭巧英,等.US3基因检测在新生儿晚期黄疸巨细胞病毒感染诊断中的应用[J].实用预防医学,2014,21(11):1380-1382.
[7] Levine D, Jani JC, Castro-Aragon I, et al. How does imaging of congenital Zika compare with imaging of other TORCH infections [J]. Radiology, 2017, 285(3):744-761.
[8] 中华医学会肝病学分会.胆汁淤积性肝病诊断和治疗共识(2015)[J].实用肝脏病杂志,2016,19(1):2-11.
[9] Min CY, Song JY, Jeong SJ. Characteristics and prognosis of hepatic cytomegalovirus infection in children: 10 years of experience at a university hospital in Korea [J]. Korean J Pediatr, 2017,60(8):261-265.