儿科住院患者巨细胞病毒感染调查  

Prevalence of Human Cytomegalovirus Infection in Hospitalized Children

作　　者：刘媛媛[1] 李珊[1] 李宁[1] 杨占秋[1] 邓幼萍[2] 聂国明 江晓静[4] 

机构地区：[1]武汉大学医学院病毒学研究所病毒学国家重点实验室,湖北武汉430071 [2]武汉大学中南医院儿科 [3]广州军区武汉总医院儿科 [4]广州军区武汉总医院感染内科

出　　处：《华南国防医学杂志》2014年第1期1-4,共4页Military Medical Journal of South China

基　　金：国家自然科学基金项目(81171586);湖北省自然科学基金项目(2010CDB09205)

摘　　要：目的通过调查住院患儿中巨细胞病毒（cytomegalovirus，CMV）感染的流行率及临床特点，探讨CMV在儿科感染中的临床意义。方法对380例儿科住院患儿的咽拭子样本采用巢式多聚酶链反应（polymerasechainreac—tion，PCR）法检测CMVDNA，微粒子酶免化学发光法定量检测血清CMVIgM和IgG，并收集相关临床资料。结果380例住院患儿中，CMV现症感染者占36．6％0。对不同年龄段CMV感染的研究结果显示，新生儿CMV感染率为60％，高度疑诊为先天性CMV感染。1～3月龄、4～6月龄、7～12月龄的CMV感染率分别为48．6％、60．0％和50．8％；1～2岁感染率为38．6％，2～3岁和3～10岁CMV感染率逐渐下降至19．3％和22．7％。在102例单纯CMV感染患儿中，除2例无症状CMV感染新生儿外，其他100例患儿均有CMV感染导致的器官损伤，表现为CMV感染性疾病。最常见的CMV感染性疾病是肺炎（35．3％）、支气管炎（33．3％）和肝炎（26．5％）。（）～6月龄组患儿CMV肝炎的发病率为55％，显著高于各年龄组患儿总发病率（P〈0．05）；新生儿的贫血发病率达50％，显著高于各年龄组患儿的总发病率（P〈0．05）。3～10岁年龄组患儿CMV感染最常见的临床表现是肺炎（52．6％）和支气管炎（57．9％），显著高于其他年龄组（P〈0．05）。结论CMV感染在儿科住院患儿中，特别是12月龄内的患儿中的流行率高，是该年龄段患儿住院治疗的主要原因之一。60％住院新生儿可能为先天性CMV感染，对新生儿应常规进行CMV感染的筛查。在住院患儿中CMV感染性疾病常见于呼吸道感染、肝炎、贫血、心肌炎、胃肠炎。0～6月龄患儿CMV感染最常见表现为肝炎，50％的CMV感染的新生儿有贫血表现。其他病原体与CMV的共感染可加重CMV导致的器官损伤。Objective Through investigating the prevalence of cytomegalovirus （CMV） infection and the clinical manifestations in hospitalized children, to study the clinical significance of CMV infection in children. Methods CMV DNA in swabs was examined by Nest polymerase chain reaction （PCR） and serum CMV IgM, IgG antibody was examined by chemiluminescence Iramunoassay （CLIA） in 380 hospitalized children. The Clinical data were collected. Results In 380 hospitalized children, the CMV infection rate was 36. 6%. In newborns it was 60% and these infected newborns were highly suspected as with congenital CMV infection. In infants aged 1-3 months, 4 6 months, 7-12 months, 1-2 years, 2- 3 years and 3-10 years old the CMV infection rate was 48. 6%, 60.0 %, 50. 8%, 38.6%, 19. 3% and 22.7% respective- ly. In 11/2 CMV infected children, the rate of clinically apparent infection was 98%. The commonest clinical manifestations were pneumonia （35.3%）, bronchitis （33. 3%） and hepatitis （26. 5%）. The incidence of hepatitis in infants aged 0-6 months old was 55%, which was significantly higher than the total incidence rate of different age groups （P〈0. 0）. In newborns, the incidence of anemia （50%） was higher than the total incidence rate of different age groups （P〈0. 05）. In children of 3-10 years old with CMV infection, the morbidities of pneumonia （52.6%） and bronchitis （57. 9%） were higher than that of other age groups （P〈0. 05）. Conclusion There is the high prevalence of CMV infection in hospitalized children, particularly in infants younger than 12 months old. CMV infection is an important reason for the hospitalization of these infants. 60% newborns might be with congenital CMV infection and it is necessary to screen CMV infection in hospitalized newborns. In hospitalized children, the common clinical manifesta- tions of CMV are respiratory infection, hepatitis, anemia, myocarditis and gastroenteritis. Additional pathogens and CMV coinfection can aggravate organs injury caused by

关 键 词：巨细胞病毒 感染 流行率 临床特点 住院患儿 

分 类 号：R511[医药卫生—内科学]