秦巴山区HCMV先天性感染更昔洛韦治疗效果探讨  

Discussion on efficacy of GCV on HCMV congenital infection in Qinba mountain area

作　　者：李琦[1,2] 李芬[1] 

机构地区：[1]西安交通大学医学院第一附属医院,陕西西安710061 [2]清华大学玉泉医院,北京100049

出　　处：《中国妇幼健康研究》2012年第3期352-354,共3页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目（30170981）

摘　　要：目的探讨秦巴山区人巨细胞病毒（HCMV）先天性感染对婴儿的影响及更昔洛韦对症状性患儿干预性治疗的效果。方法采用ELISA法检测孕妇和其所生子女血清中HCMV—IgM，PCR法检测新生儿生后2周内血清中HCMV—DNA。收集病例组中婴儿临床及实验室资料，患儿给予更昔洛韦治疗2周，追踪其疾病变化及转归。结果秦巴山区孕期HCMV宫内传播率为36．49％（27／74）；孕期HCMV活动性感染与婴儿先天性感染之间关系密切（Х^2=17．58，P〈0．001）。HCMV先天性感染可对新生儿各系统器官造成损害。有症状患儿经更昔洛韦治疗2周后HCMV转阴率为64．29％（9／14），患儿总胆红素、直接胆红素、谷氨酰转移酶、谷丙转氨酶等肝功指标明显降低。结论HCMV先天性感染对婴儿损害严重，更昔洛韦对有症状患儿有一定的治疗作用。Objective To explore the influence of human cytomegalovirus （HCMV） intrauterine transmission on neonates and the efficacy of ganciclovir （GCV） on symptomatic infants in Qinba mountain area. Methods HCMV-IgM in serum was screened in pregnant women and their babies by ELISA, and HCMV-DNA in serum of infants was detected with PCR method 2 weeks after delivery. The clinical and experimental data of infants was collected. The symptomatic infants were treated with GCV for two weeks and followed up. Results The intrauterine transmission rate of HCMC was 36.49% （27/74）in Qinba mountain area, and HCMV active infection in pregnant was closely related to HCMV congenital infection of infants （X^2 = 17.58, P 〈 0.001 ）. HCMV congenital infection would impair every system and organ of infants. Through management with GCV for 2 weeks to symptomatic infants, 64.29% （9/14） HCMV became negative, and the hepatic function indexes such as TBIL, DBIL, ALT and GGT dropped significantly. Conelusion HCMV congenital infection is serious to infants, and GCV is effective in treating symptomatic infants.

关 键 词：人巨细胞病毒 先天性感染 活动性感染 更昔洛韦 

分 类 号：R173[医药卫生—妇幼卫生保健] R373[医药卫生—公共卫生与预防医学]