婴儿肝炎综合征71例临床分析  

Clinical analysis of 71 about infant hepatitis syndrome

作　　者：江世锁[1] 杨秀珍[1] 蒋玉麟[1] 

机构地区：[1]安徽省立医院儿科,合肥230001

出　　处：《安徽医学》2004年第4期279-281,共3页Anhui Medical Journal

摘　　要：目的　分析婴儿肝炎综合征的发病原因 ,临床特征及治疗效果。方法　对符合婴儿期起病、阻塞性黄疸、肝脏肿大和肝功能障碍特征的 71例婴儿 ,进行临床资料的回顾性分析 ,并对其中 2 1例巨细胞病毒性肝炎应用更昔洛韦治疗 14例和病毒唑治疗 7例进行比较。结果　 71例婴儿肝炎综合征 ,在生后 2周内出现症状的有 44例 ( 62 %) ,生后 2～ 12周发病的有 2 4例 ( 3 4%)。 17例 ( 2 4%)合并先天性异常 ,8例 ( 11%)并发晚发性维生素K缺乏性出血。Torch血清学检查 :CMV IgM阳性 2 2例 ( 3 0 .9%) ,RV IgM阳性 2例 ( 2 .8%) ,HSV2 IgM阳性 1例。HBsAg和血培养阳性各 2例。应用更昔洛韦治疗 14例与病毒唑治疗 7例相比较 ,胆红素下降水平和肝功能的改善差异有显著意义 (P <0 .0 5 )。结论　婴儿肝炎综合征多来自先天性感染 ( 62 %)和围生期感染 ( 3 4%) ,主要由病毒感染引起 ,CMV感染占优势。诊断治疗不及时 ,预后较差 ,应加强孕期的保健和宣传工作。临床上应早期应用维生素K预防出血症 ,及时应用特异性抗病毒药物能改善预后 ,更昔洛韦是比较安全有效的抗DNA病毒药物 。Objective To analyze the etiology,clinical features and therapy efficacy of infant hepatitis syndrome.Methods Retrospective analysis of the database was performed on patients present with the onset of infant, obstructive jaundice, hepatomegaly and liver function abnormalities, of the 21 cytomegaloviral hepatitis studied, 14 patients treated with ganciclovir are compared with 7 patients treated with virazole.Results Of the 71 patients with infant hepatitis syndrome, symptoms occur in 44 patients (<2weeks newborns),24 patients(2～12weeks infants) respectively. 17 patients(24%) present congenital abnormalities, 8 patients(11%) present lated vitamin k deficiency bleeding respectively. TORCH:CMV lgM(+)22(30.9%),RV lgM(+)2 cases (2.8%),HSV lgM(+) 1 cases (1.4%),HBsAg(+)2 cases (2.8%) and blood culture positive 2 cases (2.8%) respecively. The changes of liver function and bilirubin in 14 patients treated with ganciclovir were superior to that in 7 patients treated with virazole ( P <0.05).Conclusion The majority of patients with infant hepatitis syndrome are caused by congenital infection and perinatal infection,which are infected by virus,especially cytomegalovirus. Ganciclovir is a safer and more efficient antivirus drug.

关 键 词：婴儿 肝炎综合征 临床分析 治疗 诊断 

分 类 号：R725.7[医药卫生—儿科]