淤积型婴儿肝病综合征的病毒病原检测分析(附78例报告)  

Study on viral pathogens of infantile cholestasis liver disease syndrome

作　　者：吕典一[1] 谢正德[1] 王燕[1] 闫慧敏[1] 张辉[1] 幺远[1] 胡燕[1] 闫静[1] 

机构地区：[1]首都医科大学附属北京儿童医院儿科研究所病毒室,100045

出　　处：《北京医学》2009年第12期714-716,共3页Beijing Medical Journal

基　　金：北京市中医药科技项目(JJ-2006-58)

摘　　要：目的探讨病毒感染与淤积型婴儿肝病综合征的关系。方法收集2007年3～12月在我院住院的78例淤积型婴儿肝病综合征患儿急性期和恢复期血清,进行病原学检测。采用间接ELISA法定量检测血清中巨细胞病毒(CMV)、EB病毒、单纯疱疹病毒和肠道病毒特异性IgM,荧光定量PCR法检测患者血清中CMV-DNA拷贝数,微粒子免疫发光法检测血清中乙肝病毒和丙肝病毒抗原和抗体,间接免疫荧光法检测血清中人类疱疹病毒6型(HHV-6)特异性IgM。结果78例中50例病毒病原检测阳性,阳性率为64.1%,其中人巨细胞病毒42例,阳性率为53.8%;人类疱疹病毒6型8例,阳性率为10.3%。血清中特异性EB病毒、单纯疱疹病毒、肠道病毒IgM抗体检测均阴性,乙肝病毒表面抗原和E抗原均阴性。有17例患儿进行了丙肝病毒检测,均阴性。结论CMV可能是淤积型婴儿肝病综合征的主要感染病原,HHV-6也可能与部分淤积型婴儿肝病综合征的发生相关。病毒感染诊断的确立要充分考虑血清学和分子生物学方法的意义和临床应用。Objective To investigate the relationship between viral infection and infantile cholestasis liver disease syndrome. Methods Seventy-eight cases of infantile cholestasis liver disease syndrome from Beijing Children＇s Hospital were enrolled in this study from March to December in 2007. Both acute serum and convalescent serum were collected for viral pathogens detection. Indirect quantitative ELISA was used to detect specific antibodies against human cytomegalovirus （CMV）, Epstain-Barr virus, herpes simplex virus, enterovirus. CMV-DNA copies in serum were detected by real-time PCR. Microparticle immunoluminescence assay was used to detect hepatitis B virus and hepatitis C virus. Specific antibodies against human herpes virus-6 （HHV-6） were detected by indirect immumofluorescence methods. Results Among 78 cases of infantile cholestasis syndrome, fifty cases had positive results, and the positive rate was 64.1% （50/78）. Among those positive cases, 42 had CMV infection （53.8%, 42/78） and 8 had HHV-6 infections （10.3%, 8/78）. There were no positive cases for hepatitis B virus, hepatitis C virus, Epstain-Barr virus, herpes simplex virus and enterovirus. Conclusions Human cytomegalovirus may be a main viral pathogen of infantile cholestasis syndrome and HHV-6 infections may be associated with some infantile cholestasis syndrome. The significance and clinical application of both serum assay and molecular diagnostic method must be considered when making a diagnosis of viral infection.

关 键 词：淤积型婴儿肝病综合征 婴儿 人巨细胞病毒 人类疱疹病毒6型 

分 类 号：R725.7[医药卫生—儿科]