85例巨细胞病毒感染婴幼儿的临床特征  

Clinical characteristics of 85 infants with human cytomegalovirus infection

作　　者：卢光全[1,2] 李儒贵[1] 谭华炳[1] 占国清[1] 

机构地区：[1]湖北医药学院附属人民医院感染性疾病科,十堰市442000 [2]湖北省十堰市中医院儿内科,十堰市442000

出　　处：《中华实验和临床感染病杂志（电子版）》2017年第3期282-286,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：湖北医药学院人才启动基金资助计划项目(No.2016QDJZR03)

摘　　要：目的探讨婴幼儿巨细胞病毒(CMV)感染的临床特点、治疗及预后。方法回顾性分析十堰市中医院住院治疗的85例婴幼儿CMV感染的临床资料,对该疾病的临床特点、治疗及预后进行总结。结果 85例患儿年龄9 d^3岁,≤6个月患儿占83.5%(71/85);农村和城市分布分别占78.8%和21.2%;母乳喂养、混合喂养及人工喂养分别占70.6%、21.2%和8.2%。临床表现为肺炎者60例(70.6%);婴儿肝炎38例(44.7%),无黄疸型为12例(14.1%),黄疸型为26例(30.6%)(其中胆汁瘀滞型10例、肝硬化1例、胆道闭锁2例);心肌损害9例(10.6%);贫血7例(8.2%),血小板(PLT)减少或升高7例(8.2%);脑发育异常者6例(7.1%),听力受损者3例(3.5%)。血清CMV-IgM阳性患儿46例(54.1%),血清CMV DNA阳性(≥500拷贝/ml)患儿35例(41.2%),尿CMV DNA阳性者62例(72.9%)。不同年龄组患儿肝功能损害、黄疸及肺炎的发生率差异均具有统计学意义(χ~2=10.17、P=0.017,χ~2=10.10、P=0.017,χ~2=26.00、P<0.001),而贫血、PLT计数异常、心肌损害、脑发育异常及听力受损的发生率差异均无统计学意义(P均>0.05)。治疗后好转72例,放弃治疗10例,死亡3例。结论婴幼儿感染CMV多发生在年龄≤6个月、居住在农村及母乳喂养者,临床表现多样化,以肺炎和肝炎多见;大多数CMV感染者抗病毒治疗疗效显著,少数预后较差甚至死亡。Objective To investigate the clinical characteristics, therapy and prognosis of cytomegalovirus （CMV） infection of infants. Methods Clinical data of 85 infants with CMV infection in Shiyan Traditional Chinese Medicine Hospital were collected, retrospectively. The clinical features, treatment and prognosis of the disease were analyzed, respectively. Results Total of 85 cases of infants, the ages were 9 days to 3 years, among whom, ≤ 6 months accounted for 83.5% （71/85）. The rural and urban areas were 78.8% and 21.2%, respectively; and the breast feeding, mixed feeding and artificial feeding were 70.6%, 21.2% and 8.2%, respectively. There were 60 patients （70.6%） diagnosed as pneumonia, 38 cases （44.7%） diagnosed as infant hepatitis. There were 12 cases （14.1%） showed non-jaundice and 26 cases （30.6%） showed jaundice （10 cases with bile stasis type, 1 case with cirrhosis, 2 cases with biliary atresia）. There were 9 cases （10.6%） found with myocardial damage; 7 cases （8.2%） with anemia, 7 cases （8.2%） with platelet （PLT） decreased or increased; 6 cases （7.1%） with abnormal brain development, 3 cases （3.5%） with hearing loss. And 46 cases （54.1%） were detected with positive serum CMV-IgM, 35 cases （41.2%） with positive serum CMV DNA （≥ 500 copies/ml）, while 62 cases （72.9%） with positive urinary CMV DNA. There were statistical significance in liver function damage, jaundice and pneumonia incidences among different age groups （x^2 = 10.17, P = 0.0166; Z2 = 10.10, P = 0.0173; Z2 ： 26.00, P 〈 0.001）, but with no significant difference in anemia, PLT count, myocardial injury, abnormal brain development and hearing loss （all P 〉0.05）. After treatment, 72 cases recovered, 10 cases quitted therapy and 3 cases died. Conclusions The infant with CMV infection mainly occurred among infants with age ≤ 6 months, rural residence and breastfeeding, whose clinical manifestations were diverse, mainly pneumonia and hepatitis. Most infants with CMV

关 键 词：婴幼儿 巨细胞病毒 感染 回顾性分析 

分 类 号：R725.1[医药卫生—儿科]