HCMV宫内感染对婴幼儿智力和听觉发育的影响  

Impacts of intrauterine human cytomegalovirus infection on infant＇s intelligence and hearing development

作　　者：郝海燕[1] 邓东锐[1] 闻良珍[1] 陈素华[1] 熬黎明[2] 刘兰清[3] 左伟[1] 李静[1] 凌霞珍[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430030 [2]上海第二医科大学儿科研究所,上海200092 [3]中国医科大学第二临床学院病毒研究室,辽宁沈阳110003

出　　处：《中国妇幼健康研究》2010年第6期717-718,726,共3页Chinese Journal of Woman and Child Health Research

基　　金：“九五”国家科技攻关计划资助项目（96-904-06-08）;武汉市人口计划生育委员会科研计划资助项目（WRJK0908）

摘　　要：目的 探讨人巨细胞病毒宫内感染儿的脑发育状况、认知能力及听觉发育状况.方法 采用酶联免疫吸附试验法检测4 412例孕妇外周血中HCMV IgM,对HCMV IgM阳性孕妇进一步应用逆转录-聚合酶链反应检测胎儿附属物中人巨细胞病毒晚期mRNA,其中1项阳性者为宫内感染组（92例）,2项均为阴性者为对照组（88例）,联合应用头颅超声、Bayley婴幼儿发育量表、脑干听觉诱发电位检测人巨细胞病毒宫内感染儿出生时及婴幼儿期的听力、智力发育状况.结果 宫内感染儿在出生和出生3个月时头颅超声异常率皆高于对照组（P=0.011;P=0.032）;宫内感染儿出生后4个月脑干听觉诱发电位的异常率高于对照组（χ^2=12.515,P〈0.001）.宫内感染儿智力发育指数显著落后于对照组（t=4.637,P〈0.01）;应用韦氏学龄前及幼儿智力量表（WPPSI）追踪测试患儿,其智能迟缓率仍高达20.00%.结论 人巨细胞病毒宫内感染可引起婴幼儿神经系统病变、智力发育迟缓及听力障碍.Objective To investigate statuses of brain development, intelligence and cognition ability and hearing development of infants with history of intrauterine human cytomegalovirus（HCMV） infection. Methods Enzyme-linked immunosorbent assay （ELISA） were used to detect HCMV IgM in peripheral serum of 4 412 pregnant women. HCMV mRNA were examined by RT-PCR in fetal appendages for those with positive serum HCMV IgM. 92 cases with both positive HCMV IgM and HCMV mRNA were included in infection group, and 88 cases with both negative HCMV IgM and HCMV mRNA were included in the control group. In order to monitor their neurological, andiologic and development sequelae, all infants in the two groups were evaluated by transcranial uhrasonography, Beyley Scale of Infants Development （BSID） and Brainstem Auditory Evoked Potential （BAEP） at birth and infantile period. Results The abnormal rate of transcranial ultrasonography at birth and 3 months after birth in the infection group was higher than in the control group （ P = 0. 011, 0. 032 respectively）. The abnormal rate of BAEP at 4 months after birth in those infected infants was higher than the control group （χ^2= 12.515, P 〈 0.001 ）. Mental development index （MDI） of infants in the infection group was significantly lower than the control group （t = 4.637, P 〈0.01 ）. All infected children were followed up with Wechsler Preschool and Primary Scale of Intelligence（ WPPSI）, and the mental retardation rate reached to 20.00%. Conclusion Intrauterine HCMV infection may cause infant neurological damage, mental retardation and hearing loss.

关 键 词：人巨细胞病毒 宫内感染 智力 听觉发育 

分 类 号：R373.9[医药卫生—病原生物学]