新生儿巨细胞病毒感染对肝功能与免疫功能的影响  

Effect of neonatal cytomegalovirus infection on liver function and immune function

作　　者：王智灵 陈小建[2] 陈锋[1] 郑肖瑾 WANG Zhi-ling;CHEN Xiao-jian;CHEN Feng;ZHENG Xiao-jin(The Women and Children Hospital of Hainan Province,Haikou,Hainan 570206,China;不详)

机构地区：[1]海口市妇幼保健院新生儿科,海南海口570206 [2]海口市人民医院儿科,海南海口570208

出　　处：《中华医院感染学杂志》2020年第3期428-432,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(14A200042)。

摘　　要：目的探讨分析新生儿巨细胞病毒感染对肝功能指标总胆红素(TBIL)、丙氨酸氨基转肽酶(ALT)、天冬氨酸氨基转肽酶(AST)、谷氨酰转肽酶(GGT)水平、血清免疫球蛋白G(Immunoglobulin,IgG)、IgA、IgM及IgE水平及外周血T淋巴细胞亚群免疫功能的影响。方法选择2016年3月-2018年7月海口市妇幼保健院收治的巨细胞病毒感染(Cytomegalovirus,CMV)新生儿113例,其中潜伏性CMV感染患儿75例作为潜伏组,活动性CMV感染患儿38例作为活动组,另选择同期健康新生儿50名作为对照组。检测三组新生儿肝功能指标TBIL、ALT、AST、GGT变化情况及血清免疫球蛋白、外周血T淋巴细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)变化结果活动组患儿肝功能指标TBIL、ALT、AST、GGT分别为(23.81±5.62)μmol/L、(58.37±17.23)U/L、(79.68±21.87)U/L、(22.14±6.38)U/L均高于潜伏组(9.12±2.26)μmol/L、(22.05±6.10)U/L、(46.17±12.56)U/L、(17.95±4.11)U/L和对照组(P<0.05),其中潜伏组患儿肝功能各指标高于对照组(P<0.05)。三组新生儿血清免疫球蛋白IgG、IgA、IgM及IgE水平比较差异无统计学意义。活动组患儿外周血CD4^+、CD4^+/CD8^+水平分别为(37.84±10.63)%、(1.20±0.28)低于潜伏组(45.27±7.22)%、(1.64±0.40)和对照组(P<0.05),而活动组CD8^+水平高于潜伏组和对照组(P<0.05),且潜伏组CD4^+、CD4^+/CD8^+水平低于对照组(P<0.05),潜伏组CD8^+水平为(27.14±1.95)%高于对照组(P<0.05),三组新生儿自然杀伤(NK)细胞比较差异无统计学意义(P=0.462)。结论巨细胞病毒感染可引发新生儿肝功能损害及抑制细胞免疫功能,而对机体体液免疫功能无明显影响,其中活动性巨细胞病毒感染对机体的影响最大。OBJECTIVE To investigatet the effect of neonatal cytomegalovirus infection on liver function indicators,including total bilirubin(TBIL),alanine aminotranspeptidase(ALT),aspartate aminotranspeptidase(AST),glutamyl transpeptidase(GGT)levels,serum immunoglobulin(Ig)IgG,IgA,IgM,and IgE levels and peripheral blood T lymphocyte subsets,and immune function.METHODS A total of 113 neonates with CMV infection admitted to the Women and Children Hospital of Hainan Province from Mar.2016 to Jul.2018 were selected as the study subjects,of which 75 children with latent CMV infection were assigned to latent groupand 38 children with active CMV infection were assigned to active group,and 50 healthy neonates were selected as control group.The changes of TBIL,ALT,AST,GGT,serum immunoglobulin,complement and T lymphocyte subsets(CD4^+,CD8^+,and CD4^+/CD8^+)in peripheral blood were detected in the three groups.RESULTS The liver function indexes including TBIL,ALT,AST and GGT in actvie group were(23.81±5.62)μmol/L,(58.37±17.23)U/L,(79.68±21.87)U/L,and(22.14±6.38)U/L,respectively,significantly higher than those in latency group of[(9.12±2.26)μmol/L,(22.05±6.10)U/L,(46.17±12.56)U/L,and(17.95±4.11 U/L),respectively]and in control group(P<0.05),and the liver function of the latent group was significantly higher than that of the control group(P<0.05).There were no significant differences of serum immunoglobulin IgG,IgA,IgM and IgE levels among the three groups.The CD4^+and CD4^+/CD8^+levels in peripheral blood in the active group were(37.84±10.63)and(1.20±0.28),respectively,lower than those in latent group(45.27±7.22)and(1.64±0.40),respectively)and control group(P<0.05),while CD8^+level in active group was significantly higher than that in latent group and control group(P<0.05).The levels of CD4^+and CD4^+/CD8^+in latent group were significantly lower than those in control group(P<0.05),and the CD8^+level in tlatent group was(27.14±1.95),significantly higher than that in control group(P<0.05).There was no significant differen

关 键 词：新生儿 巨细胞病毒感染 肝功能 免疫功能 

分 类 号：R511[医药卫生—内科学]