先天性巨细胞病毒感染早产儿的近期随访观察  

The short term follow-up observation of premature infants with congenital HCMV infections

作　　者：王冰 王永波 孙继飞 王盈 孙晓华 徐玲玲 

机构地区：[1]威海市妇女儿童医院新生儿科,山东省威海264200

出　　处：《中国医师杂志》2013年第9期1179-1182,共4页Journal of Chinese Physician

摘　　要：目的探讨先天性巨细胞病毒感染（cytomegalovirus，CMV）的早产儿1岁前发生的相关并发症及生长发育情况。方法先天性CMV感染早产儿58例及对照组60例早产儿进行了为期1年的前瞻性随访，其随访期内容包括：体格检查、肝功能、头颅B超、脑干听觉诱发电位（auditorybrainsemresponse，ABRs）。比较两组早产儿生长发育及相关并发症发生情况的差异。结果观察组早产儿肝炎综合征和早产儿脑病、感音神经性耳聋（sensorineuralheatingloss，SNHL）的发生率高于对照组[22．41％（13／58）vs8．33％（5／60），60．34％（35／58）VS25．00％（15／60），36．21％（21／58）VS13．33％（8／60），x^2=4．52，P〈0．05；x^2=15．09，12．71，P〈0．01]。体格发育迟缓率与对照组比较差异无统计学意义（P〉0．05）。观察组3、6个月肝功能异常率（x。=8．33、17．28，P〈0．01），出生时、3个月头颅B超异常率（x^2=15．09，P〈0．01；x^2=5．38，P〈0．05），3、6个月ABRs的异常率均高于对照组（x^2=17．01、8．04，P〈0．01）。结论先天性CMV感染的早产儿更易合并肝炎综合征、早产儿脑病及SNHL。对此患儿应进行肝功能、头颅B超及ABRs的定期检测，可早期发现患儿的异常情况，并及时进行有效干预，能改善患儿预后。Objective To investigate correlative complication and disorders in growth of premature infants with congenital CMV infections before one year old. Methods Fifty-eight infected premature infants and sixty control premature infants were followed up prospectively for one year. The differences were com- pared between two groups with incidence of correlative complication. Physical growth, liver function, neu- rosonographie and audiologic examination were used to identify the sequelae of CMV infections. Results The numbers of infants with infantile hepatitis syndrome, encephalopathy of premature infant and SNHL were significantly higher in infected group than in control group（x2 =4. 52, 15.09, 12. 71, P 〈0. 05）. No difference between groups was found on physical growth. However, the significant difference between two groups was observed on abnormal for liver function of 3 and 6 months（ X2 = 8.33, 17.28, P 〈 0.05 ） , neu- rosonographic after birth and 3 months（ X2 = 15.09, 5.38, P 〈 0. 05 ）, audiologic examination of 3 and 6 months （ X2 = 17. 01, 8.04, P 〈 0.05 ）. Conclusions These data suggest that congenital CMV infections may be associated with hepatitis syndrome, encepbalopathy of premature infant and SNHL in premature in- fants. Liver function, neurosonograpphic imaging and ABRs were useful in the evaluation of the premature infants with congenital CMV infections.

关 键 词：巨细胞病毒感染 先天性 婴儿 早产 听觉丧失 感音神经性 肝炎 综合征 随访研究 

分 类 号：R722.6[医药卫生—儿科]