巨细胞病毒感染新生儿及小婴儿的临床特征及免疫功能变化  

Clinical Characteristics and Immune Function Change of Cytomegalovirus Infection in Newborn Infants and Little Infants

作　　者：荣丽英[1] 刘晓军[1] 李维超[1] 陈净[1] 郭静[1] 

机构地区：[1]天津市儿童医院内科,天津300074

出　　处：《实用儿科临床杂志》2008年第22期1765-1767,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨巨细胞病毒(CMV)感染患儿临床表现、诊治措施、疾病转归及免疫功能的变化。方法CMV患儿52例。临床表现为单纯CMV感染15例(29%),CMV肝炎12例(23%),CMV炎性反应11例(21%),CMV肺炎6例(12%),皮疹4例(7%),CMV脑炎、宫内发育迟缓各2例(各4%)。每周取指端血2次,6μL/次,检测其WBC总数、分类及PLT计数;患儿入院时及治疗过程中取股静脉血监测CRP,采用分子生物学方法进行病原学检查;同时行肝功能检查和采用流式细胞检测仪对血标本进行细胞免疫功能检测(即淋巴细胞计数)。结果1.CMV患儿52例血常规:WBC计数>20×109L-12例(4%),(10～20)×109L-118例(35%),其余患儿WBC计数正常。46例(88%)淋巴细胞增多;12例(23%)PLT计数<100×109L-1,其余患儿淋巴细胞及PLT计数均正常。2.CRP:11例(21%)>20mg/L,余患儿CRP<20mg/L。3.肝功能检查:血清GPT轻度增高,γ-谷氨酰转移酶增加且>300U/L者10例。4.病原学检查:CMV-PCR阳性例数尿液明显大于血液。5.细胞免疫功能检测:3例细胞免疫功能异常,治疗前总T淋巴细胞及辅助T淋巴细胞降低,且辅助T淋巴细胞与抑制T淋巴细胞比值降低,抗病毒治疗后均恢复正常。结论我国CMV有很高的感染率,由于新生儿的免疫特性,易造成炎性反应扩散及器官功能损害,对产毒型感染患儿要进行正规抗病毒和增加机体免疫功能的方法。Objective To explore the clinical manifestations, diagnosis and treatment, restoration of disease and immune function change of pediatric patients infected by cytomegalovirus （CMV）. Methods The clinical manifestations of 52 CMV patients ：15 cases （29%） of common infections, 12 cases （23 % ） of hepatitis, 11 cases （21% ） of inflammatory reactions ,6 cases （ 12% ） of pneumonia ,4 cases （7%） of rash ,2 cases （4%） of CMV encephalitis and 2 cases of （4%） intrauterine growth restriction. The examination of peripheral blood,including leucocyte counts and classification and platelet counts ,were performed twice ,6 p.L/time. C - reaction protein （CRP） using femoral vein were tested right after admission and during treatment period. The molecular biology technique was used to detect pathogens. Liver function examination was also performed. Moreover,the examination of cell immune function was done using the flow eytometer to test lymphocyte counts. Results l. Blood test ： white blood counts of 2 cases （4%） exceeded20×10^9 L^-1,andl8cases （35%） in the area of （10 -20） ×10^9L^-1,the other patients were all normal. The lymphocyte counts in 46 cases （88%） increased and the thrombocyte counts in 12 cases （23%） were less than 100 × 10^9 L ^-1 ,the lymphocyte and thrombocyte counts of other patients were all normal. 2. CRP：1 1 cases （21%） exceeded 20 mg/L, others were 〈 20 mg/L. 3. Liver function：the serum LGPT of patients slightly increased, and the γ- glutamate pyruvate transaminase of 10 cases increased and exceeded 300 U/L. 4. Pathogen detection：for CMV - PCR in urea and blood, the positive cases in urea were obviously more than those in blood. 5. Cell immune function ：3 cases had abnormal cell immune function ; the total T lymphocyte and assistant T lymphocyte decreased and became normal after anti - virus treatment. The ratio of assistant T lymphocyte and suppressor T lymphocyte also decreased and recovered after the treatment. Conclusions High CMV

关 键 词：巨细胞病毒 诊断 治疗 免疫 婴儿 新生 

分 类 号：R725.1[医药卫生—儿科]