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中华实验和临床感染病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (03) : 282 -286. doi: 10.3877/cma.j.issn.1674-1358.2017.03.016

临床论著

85例巨细胞病毒感染婴幼儿的临床特征
卢光全1, 李儒贵2,(), 谭华炳2, 占国清2   
  1. 1. 442000 十堰市,湖北医药学院附属人民医院感染性疾病科;442000 十堰市,湖北省十堰市中医院儿内科
    2. 442000 十堰市,湖北医药学院附属人民医院感染性疾病科
  • 收稿日期:2016-04-15 出版日期:2017-06-15
  • 通信作者: 李儒贵
  • 基金资助:
    湖北医药学院人才启动基金资助计划项目(No. 2016QDJZR03)

Clinical characteristics of 85 infants with human cytomegalovirus infection

Guangquan Lu1, Rugui Li2,(), Huabing Tan2, Guoqing Zhan2   

  1. 1. Department of Infectious Diseases, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China; Department of Pediatric, Shiyan Traditional Chinese Medicine Hospital, Shiyan 442000, China
    2. Department of Infectious Diseases, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China
  • Received:2016-04-15 Published:2017-06-15
  • Corresponding author: Rugui Li
引用本文:

卢光全, 李儒贵, 谭华炳, 占国清. 85例巨细胞病毒感染婴幼儿的临床特征[J]. 中华实验和临床感染病杂志(电子版), 2017, 11(03): 282-286.

Guangquan Lu, Rugui Li, Huabing Tan, Guoqing Zhan. Clinical characteristics of 85 infants with human cytomegalovirus infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(03): 282-286.

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(χ2 = 10.17、P = 0.017,χ2 = 10.10、P = 0.017,χ2 = 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 (χ2 = 10.17, P = 0.0166; χ2 = 10.10, P = 0.0173; χ2 = 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 infection had significant antiviral effect, and just a few were with poor prognosis or even death.

表1 85例HCMV感染患儿的年龄、性别、居住地和喂养史
表2 85例HCMV感染患儿肝功能异常和血白细胞计数分类
表3 不同年龄组HCVM感染临床表现的发生率[例(%)]
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