不同gH基因型别先天性人巨细胞病毒感染新生儿临床特征  

Clinical characteristics of neonates infected with congenital HCMV with different gH genotype

作　　者：郑雯 黄杰[1] 杨树杰[1] 易海英[1] 甘斌[1] 王艳华[1] ZHENG Wen;HUANG Jie;YANG Shu-jie;YI Hai-ying;GAN Bin;WANG Yan-hua(Xiaogan Hospital Affliated to Wuhan University of Science and Technology Xiaogan,Hubei 432100,China)

机构地区：[1]湖北省武汉科技大学附属孝感医院新生儿科,湖北孝感432100

出　　处：《中华医院感染学杂志》2022年第11期1732-1736,共5页Chinese Journal of Nosocomiology

基　　金：湖北省科研基金资助项目(Q214200)。

摘　　要：目的探讨不同人巨细胞病毒(HCMV)包膜糖蛋白H(gH)基因型别先天性HCMV感染新生儿的临床特征。方法选取2018年2月—2021年2月武汉科技大学附属孝感医院确诊的110例先天性HCMV感染新生儿为研究对象,根据尿液HCMV gH分型结果分为gH1组68例和gH2组42例。收集两组患儿新生儿期临床资料包括临床表现、实验室检查、听力以及神经系统预后评估情况。结果110例先天性HCMV感染新生儿中,gH基因型分布以gH1型为主(61.82%,68/110),无混合型感染。gH1组出现血小板减少患儿的比例高于gH2组(P<0.05),两组出现宫内生长受限、脾肿大、肝肿大、瘀斑、脉络膜视网膜炎、颅内钙化和症状性感染患儿的比例均无统计学差异;gH1组血小板水平低于gH2组,总胆红素水平高于gH2组(P<0.05)。gH1组和gH2组出现听力损失患耳的比例无统计学差异,gH1组听力损失程度达中重度及以上的患耳比例高于gH2组(P<0.05)。gH1组Alarcon评分低于gH2组(P<0.05)。结论医院先天性HCMV感染新生儿中,gH1型为优势基因型;gH1基因型在新生儿期中重度以上程度听力损失患儿中比gH2型更常见,而gH2基因型HCMV感染患儿具有更高的神经系统损害风险。OBJECTIVE To investigate the clinical characteristics of congenital human cytomegalovirus(HCMV)-infected neonates with different HCMV envelope glycoprotein H(gH)genotype.METHODS A total of 110 neonates with congenital HCMV infection diagnosed in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from Feb.2018 to Feb.2021 were collected as the research subjects,and divided into 68 cases of gH1 group and 42 cases of gH2 group according to genotypes of urine HCMV gH.The neonatal clinical data in both groups were collected,including clinical manifestations,laboratory examinations,hearing and neurological prognosis evaluation.RESULTS Among the 110 neonates with congenital HCMV infection,gH genotype distribution was dominated by gH1 type(61.82%,68/110),and there was no mixed infection.The proportion of thrombocytopenia cases in gH1 group was significantly higher than that in gH2 group(P<0.05).There was no significant difference in the proportions of children with intrauterine growth restriction,splenomegaly,hepatomegaly,ecchymosis,chorioretinitis,intracranial calcification and symptomatic infection between the two groups.The platelet level in gH1 group was significantly lower than that in gH2 group,and level of total bilirubin was higher than that in gH2 group(P<0.05).There was no significant difference in the proportion of cases with hearing loss between the gH1 and the gH2 groups.The proportion of cases with moderate to severe hearing loss in the gH1 group was significantly higher than that in gH2 group(P<0.05),and the Alarcon score of the gH1 group was significantly lower than that in gH2 group(P<0.05).CONCLUSION Among neonates with congenital HCMV infection in the hospital,gH1 was the dominant genotype,which was more common than gH2 type in neonates with moderate to severe hearing loss,while the gH2 genotype in neonates with HCMV infection had higher neurological system injury risk.

关 键 词：人巨细胞病毒 包膜糖蛋白H 基因型 临床特征 听力 神经系统发育 新生儿 感染 

分 类 号：R722.13[医药卫生—儿科]