新生儿先天性巨细胞病毒感染的临床研究  

Clinical Study on Congenital Cytomegalovirus Infection in Newborn Infants

作　　者：陈平洋[1] 贺晓日[1] 王涛[1] 邱梅冰[1] 闫淑媛[1] 杨成华[2] 胡劲涛[1] 薄涛[1] 谢宗德[1] 

机构地区：[1]中南大学湘雅二医院新生儿科,长沙410011 [2]美国科罗拉多州立大学生物化学与分子生物学系,科罗拉多州80526

出　　处：《实用儿科临床杂志》2007年第22期1697-1698,1728,共3页Journal of Applied Clinical Pediatrics

基　　金：湖南省科技厅项目资助(04SK3045-1)

摘　　要：目的探讨新生儿先天性巨细胞病毒(CMV)感染的临床特征以及更昔洛韦治疗的临床疗效及其对预后的影响。方法先天性CMV感染新生儿73例分为试验组(n=32)、对照组(n=41)。二组患儿均给予茵栀黄退黄、蓝光照射、丙种球蛋白等对症支持治疗。试验组加用更昔洛韦[7.5mg/(kg.次)]治疗;对照组未使用更昔洛韦。观察更昔洛韦的临床疗效,并比较二组转归情况。结果1.临床特征:73例患儿均有症状性感染,以全身性感染为主(80.8%);消化系统受累最常见(95.89%),病理性黄疸是其主要首发症状和主要临床表现(95.89%);病程中可并其他病原微生物感染,以机会菌败血症最常见(14.1%);出生缺陷发生率为6.4%。2.临床疗效:试验组治疗后临床表现、辅助检查、病原学检查阴转率与对照组比较均有显著性差异(Pa<0.001,0.005)。3.转归:试验组痊愈26例(81.3%),显效6例(18.7%);对照组进步14例(34.1%),未愈27例(65.9%),二组临床疗效比较有显著性差异(P<0.005)。结论新生儿先天性CMV感染主要表现为有症状性全身性感染,及时予更昔洛韦正规治疗,能明显改善预后。Objective To explore the clinical characteristics of neonatal congenital cytomegalovirus （CMV） infection,and evaluate the effi- ciency of Ganciclovir therapy and its effect on prognosis, Methods The 73 neonates with congenital CMV infection were divided into experimental group （n = 32 ） and eoutrnl group （n = 41 ）. The patients of two groups were given Yinzhihuang,blue - light exposured and gammaglobulin treatment. The patients of experimental group were curod with ganciclnvir [7.5 mg/（ kg· time） ] ,but not in control group. The negative rates of clinical symptnm,assistant examination,palhogenic examination of experimental grnup （n = 32） and their prognosis ＇after treated with formal Ganciclovir therapy were observed. Results 1. Clinical characteristics：All of the 73 patients observed in our study had symptoms after the infection. Most of them had infection all over their body （ 80, 8% ）. The digesting system infection was the most frequent （95, 89% ）, Pathological jaundice was the major first - appearing symptom and major clinical symptom （95.89%）. lntections by other microbial pathogens during disease progression were alsn observed, chance bacterial sepsis was most often seen （ 14. 1% ）. The chance of having born defection complication was 6.4%. 2. Clinical effect ： After the treatment, the vanishment of clinical symptom, assistant examination, pathogenic examination of experimental group differs from the cnntrol group significantly（ Pa 〈 0.001,0. 005 ）. 3. Prognosis ： In experiment group, 26 infants were cured （ 81.3 % ） ,6 infants showed effectiveness （ 18.7% ）. In control group, 14 infants showed effectiveness （34. 1% ） ,27 infants showed no effectiveness （65.9%）. There was significant difference nf curative effect in two groups（ P 〈 0. 005 ）. Conclusions The major symptom of neonatal congenital CMV infection is whole body infection,and formal Ganciclovir h＇eatment is effective in clinic,it can remarkahly improve the prognosis of the

关 键 词：婴儿 新生 巨细胞病毒 先天性 感染 

分 类 号：R722.1[医药卫生—儿科]