血锌和T淋巴细胞亚群及尿CMV DNA水平诊断CMV感染相关性IHS的临床价值  

Clinical value of blood zinc,T lymphocyte subsets and urine CMV DNA in diagnosis of CMV infection-associated IHS

作　　者：唐倩[1] 张寅[1] 王颖源 TANG Qian;ZHANG Yin;WANG Ying-yuan(The First People's Hospital of Shangqiu,Shangqiu,Henan 4761o0,China;不详)

机构地区：[1]商丘市第一人民医院新生儿科,河南商丘476100 [2]河南省(郑州)儿童医院新生儿科,河南郑州450000

出　　处：《中华医院感染学杂志》2023年第18期2860-2863,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关项目(LHGJ20190957)。

摘　　要：目的分析巨细胞病毒(CMV)感染相关性婴儿肝炎综合征(IHS)患儿血锌和T淋巴细胞亚群及尿CMV DNA水平及其诊断价值.方法纳入2018年5月-2022年5月商丘市第一人民医院收治的117例CMV感染患儿为病例组(IHS患儿56例,非IHS患儿61例)及52名健康新生儿为对照组,检测血锌和T淋巴细胞亚群及尿CMVDNA水平,受试者工作特征(ROC)曲线分析上述指标诊断CMV感染相关性IHS的临床价值.结果病例组血锌、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平均低于对照组(P<0.05);IHS组血锌、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平均低于非IHS组,尿CMVDNA水平高于非IHS组(P<0.05);血锌、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、尿CMV DNA及联合检测诊断CMV感染相关性IHS的曲线下面积(AUC)分别为0.731、0.639、0.713、0.847及0.940;IHS组血锌、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)水平随病情严重程度的加重而降低,尿CMV DNA水平随病情严重程度的加重而升高(P<0.05).结论CMV感染相关性IHS患儿存在血锌水平降低及免疫功能异常现象,血锌、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)及尿CMV DNA水平联合检测对CMV感染相关性IHS具有较高的诊断价值,且各指标水平与IHS严重程度有关.OBJECTIVE To observe the levels of blood zinc,T lymphocyte subsets and urine cytomegalovirus(CMV)DNA in the children with CMV infection-associated infantile hepatitis syndrome(IHS)and analyze the diagnostic values.METHODS A total of 117 children with CMV infection who were treated in the First People's Hospital of Shangqiu from May 2018 to May 2022 were assigned as the case group,56 of whom had IHS,and 61 did not have IHS.52 healthy neonates were chosen as the control group.The levels of blood zinc,T lymphocyte subsets and urine CMV DNA were detected,and the clinical values of the above indexes in diagnosis of CMV infection-associated IHS were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of blood zinc,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the case group were lower than those of the control group(P<0.05);the levels of blood zinc,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the IHS group were lower than those of the non-IHS group,while the urine CMV DNA level of the IHS group was higher than that of the non-IHS group(P<0.05).The areas under curves(AUCs)of the blood zinc,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),urine CMV DNA and the joint detection of the indexes were respectively 0.731,0.639,0.713,0.847 and 0.940 in diagnosis of the CMV infection-associ-ated IHS.The levels of blood zinc,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the IHS group were reduced with the aggravation of illness condition,while the urine CMV DNA level was elevated with the aggravation of illness condition(P<0.05).CONCLUSION The children with CMV infection-associated IHS show the decline of blood zinc and abnormal immune function.The joint detection of blood zinc,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)and urine CMV DNA has high value in diagnosis of the CMV infection-associated HIS,and the levels of the indexes are associated with the severity of IHS.

关 键 词：巨细胞病毒 感染 婴儿肝炎综合征 血锌 T淋巴细胞亚群 

分 类 号：R725.7[医药卫生—儿科]