黄疸婴儿及其母亲巨细胞病毒标志物检测的意义

采用酶联免疫吸附法检测血清抗巨细胞病毒(CMV)IgM和抗CMV·IgG,应用原位杂交法检测尿CMV—DVA证实为CMV肝炎患儿40例,用同种方法检测患儿母亲40例,结果80％患儿母亲CMV标志物阳性。先天感染组肝功能损害及肝脾肿大的程度明显重于围产组和生后感染组(P<0.01),而且重症病死率高达33.3％,但幸存的CMV肝炎患儿肝脏病变大多能恢复,一般不发生慢性肝脏病变。婴儿CMV感染的主要途径可能源于母婴间的垂直传播和水平传播。     

更昔洛韦治疗婴儿巨细胞病毒肝炎32例分析

目的　分析婴儿巨细胞病毒 (CMV)肝炎的临床特征及观察更昔洛韦的临床疗效。方法　观察更昔洛韦正规治疗的 32例婴儿CMV肝炎治疗前后血清总胆红素水平、肝脏酶 (ALT、AKP、γ -GT)变化及肝脾大小 ,同时观察药物不良反应。结果　婴儿CMV肝炎多以黄疸为首发症状 (87.5 % ) ,多有肝脾肿大 (93 .75 %、46.88% )。应用更昔洛韦治疗后 ,在 (1 3± 3)d后血清胆红素及肝酶下降、肝脾回缩。未见更昔洛韦的明显毒副作用。结论　对以黄疸为首发症状的婴儿应警惕CMV肝炎可能 ,更昔洛韦治疗CMV感染是安全有效的。     

婴儿巨细胞病毒性肝炎37例临床分析

目的探讨婴儿巨细胞病毒性肝炎(CMV肝炎)的临床特点、疗效及预后。方法回顾分析我院1995年1月—2000年1月收治的37例婴儿CMV肝炎的临床资料。结果先天性感染组的TBIL、GGT及病死率均明显高于围生期感染组；死亡组患者的肝肿大、TBIL、DBIL、GGT明显高于治愈组；使用丙氧鸟苷治疗较一般综合治疗可显著缩短退黄时间(t=3.4562，P＜0.01)，使用干扰素治疗与一般综合治疗比较退黄时间无明显差异(t=1.1269，P＞0.05)。结论婴儿CMV肝炎发病越早，肝功能损害越严重，预后越差；使用丙氧鸟苷治疗可显著缩短退黄时间。     

更昔洛韦治疗婴儿肝炎综合征的临床观察

目的了解婴儿肝炎综合征巨细胞病毒（CMV）感染情况，观察更昔洛韦治疗CMV肝炎的临床效果。方法对60例临床诊断婴儿肝炎综合征患儿进行血清CMV-IgM检测，将CMV-IgM阳性的35例患儿随机分成两组：对照组15例静滴病毒唑治疗，治疗组20例静滴更昔洛韦治疗,结果婴儿肝炎综合征患儿CMV感染率为58．33％。治疗组总有效率（85．00％）明显高于对照组（40．00％）；治疗2周后血清总胆红素水平的恢复、谷丙转氨酶值等治疗组均优于对照组（P分别为0．00071、0．00052、．绪俭垂普洛丰治疗晕儿肝炎综合征安全、有效．     

婴儿巨细胞病毒性肝炎GM-CSF、CRP和TNFα检测的临床意义

目的 探讨粒细胞-巨噬细胞集落刺激因子(GM-CSF)、C反应蛋白(CRP)和肿瘤坏死因子α(TNFα)在婴儿巨细胞病毒(CMV)肝炎发病中的作用.方法 56例CMV肝炎患者和51例正常对照者,用荧光探针PCR法定量检测血液中巨细胞病毒DNA(HCMV-DNA),用双抗体夹心法ELISA检测血清中的GM-CSF和TNFα水平, 用免疫比浊法检测血液中CRP含量.结果 婴儿巨细胞病毒肝炎患者血清中GM-CSF、CRP和TNFα水平明显高于正常对照组(P＜0.01, P＜0.01,P＜0.01).结论 GM-CSF、TNFα和CRP参与婴儿巨细胞病毒肝炎的免疫病理反应和抗病毒免疫.     

婴儿肝炎综合征巨细胞病毒感染的有关问题探讨

目的探讨婴儿肝炎综合征巨细胞病毒（CMV）感染的有关问题。方法观察65例出生3d～7个月婴儿肝炎综合征患儿,探讨其病因、CMV感染的途径、临床表现、诊断、治疗及预防。结果婴儿肝炎综合征主要由CMV感染引起,肝是受损害最常见的部位,母婴之间传播是先天性CMV感染和1岁内获得性感染的重要来源。结论确诊患儿是否因CMV感染须借助于病毒学与血清学的检测,对CMV感染的治疗,主要是对有症状感染时的对症处理,积极预防是十分重要的。     

巨细胞病毒感染致婴儿肝炎综合征的实验室指标分析

目的 分析巨细胞病毒(CMV)感染致婴儿肝炎综合征(IHS)患儿血氨水平与肝功能指标之间的相关性,探讨血氨水平对评估CMV感染致IHS病情的临床价值。 方法 选取130例IHS患儿作为研究组,同期选取健康体检的130例婴儿作为对照组。采用化学发光法测定两组婴儿血清CMV-IgM水平,采用荧光定量PCR测定尿HCMV-DNA; 采用全自动生化分析仪检测52例CMV感染致IHS患儿的血氨及肝功能指标,并分析血氨与肝功能水平的相关性。随访12月,观察CMV感染与治疗后复发率的关系。 结果 研究组的血清CMV-IgM阳性率为36.15%,尿HCMV-DNA阳性率为40.0%,均显著高于对照组(P<0.001)。CMV感染致IHS患儿中不同血氨水平亚组各肝功能指标比较,差别均无统计学意义(P>0.05); 相关分析显示,CMV感染致IHS患儿血氨水平与各肝功能指标均无相关性(P均>0.05),而与血清白蛋白(ALB)呈负相关(Pearson相关系数为-0.594,P<0.001)。CMV感染阴性的IHS复发率为3.85%,明显低于CMV感染阳性患儿的11.54%(χ²=5.686, P=0.017)。 结论 血氨水平联合血清ALB可以反映CMV感染致IHS患儿的病情变化,有助于CMV感染致IHS的早期诊断和治疗。     

孕妇宫颈巨细胞病毒分离及其母婴传播的初步探讨

孕妇宫颈巨细胞病毒(CMV)排出率为4.12％(8/193)。宫颈排出CMV的母亲所分娩的6名婴儿中有4名受感染,其中1名从唾液和尿排出CMV长达7个月以上。从3名母亲的乳汁分离出CMV,其中1名特续存在1个月以上。3名从宫颈分泌物和乳汁排出CMV者,其婴儿均受到感染。结果表明CMV在母婴之间传播。     

更昔洛韦治疗巨细胞病毒性肝炎疗效观察

<正>巨细胞病毒(CMV)广泛存在,绝大多数为无症状的隐性感染,5%～10%有症状表现,称之为全身性巨细胞病毒感染。CMV感染多见于小婴儿,可分为先天感染,围产期感染以及生后感染3个类型。婴儿肝炎综合征指1岁以内婴儿由不同病菌引起,以黄疸、肝功能损害、肝脾肿大为主要临床表现特征的疾病。近年来发现婴儿肝炎综合征病因以巨细胞病毒感     

γ-谷氨酰转肽酶在巨细胞病毒肝炎中的意义

婴儿期感染巨细胞病毒(CMV),尤其是先天性和围产期感染常累及肝脏,其黄疸型往往以婴儿肝炎综合征就诊。本文对本院收治的80例CMV,肝炎患儿进行肝功能测定,并分析其在病程中的临床意义。     

Hepatitis C virus infection in different groups of children in Wuhan area

Summary To investigate the incidence of child’s HCV infection in our area, 637 children with different background, including 65 posttransfusion cases, 419 hepatitis patients (250 cases of acute hepatitis A, 156 cases of chronic hepatitis B and 13 cases of non-A, non-B hepatitis), 50 infantile hepatitis syndrome (1HS) infants and 103 healthy day-cared children were tested for serum anti-HCV antibody (EIA) and HCV RNA (nested PCR). It was found that posttransfusion children had significantly higher anti-HCV positive rate (30. 8%) and HCV infection incidence (43.1%) than hepatitis patients (4.3% and 5.3%), IHS infants (6.0% and 8.0%) and daycared children (2.9% and 2.9%). 25 of 33 cases with posttransfusion hepatitis (PTH) developed hepatitis C, which was the leading cause of PTH (75.8%) and NANB PTH (25/30, 83.3%). The incidence of HCV infection in NANBH patients was 23.1% (3/13) which was apparently higher than that in day-cared children (P <0. 02) and lower than that in PTH patients (P<0. 001), but not statistically different from that in AHA and CHB patients (P>0. 05). Mother-infant paired study in IHS group showed that 4 pairs of mother-infant had HCV infection, one boy aged 8 months and his mother were anti-HCV positive, and another 3 pairs possessed HCV RNA in sera. 3 of 103 healthy day-cared children were found to have inapparent HCV infection, who were anti-HCV and HCV RNA positive.     

A clinical study of cytomegalovirus infections during pregnancy

Summary Enzyme-linked Immunosorbent Assay (ELISA) was adopted to detect the human cytomegalovirus (HCMV) specific IgG, IgM in the blood samples of 216 pregnant women and the umbilical cord blood, as well as the HCMV antigen in the urine specimens of 91 newborn infants. Emphasis was put on the occurrence of cytomegalovirus infection during pregnancy and influence on both the mother and the infant. Our experimental results showed that HCMV IgG positive rate in the maternal sera as well as in cord sera was 93.98%; HCMV IgM positive rates were 8.8% in maternal sera and 3.7% in cord sera, respectively. In maternal sera IgG-positive group, 31.6% cord sera showed also HCMV IgG positive results. In 91 urine specimens of newborn infants, HCMV-Ag positive specimens accounted for 10.98% (10 cases). The rates of abortion, congenital malformation, stillbirth, premature fetal death, and intrauterine growth retardation (IUGR) were all apparently higher in the HCMV-IgM positive pregnant group than in the HCMV-IgM negative group. The infants of HCMV-IgM positive mothers also showed lower birth weight, height, biparietal diameter, suboccipitobregmatic diameter, occipitofronatal diameter, occipito-mental diameter than the infants of HCMV-IgM negative mothers. Meanwhile, the growth and development indices of the former showed a tendency to decrease. Placenta histological examination showed thac HCMV-IgM positive group had a higher incidence of pathological changes than HCMV-IgM negative group. Altogether, there were 8 cases of cogenital infections.     

Cytomegalovirus Infection in Children's Liver Tissues

Humancytomaglovirus(HCMV)infectioninchildrenisverycommonandisoneofthecausesofinfantilehepatitissyndrome(IHS)[lj.ThedetectionofHCMVinthesamplesofurine,salivaandserumcouldnotdirectlyreflecttheHCMVinfectioninlivertissues,becauseHCMVisdemonstratedtohaveawidetissuetropism.Inthisstudy,immediateearlyantigen(IEA)andearlyantigen(EA)ofHCMVinfectioninlivertissueweredetectedin72patientsbyusingimmunoperoxidasehistochemicalstaining.1METERIALSANDMETHODS1.1SamplesOf72samplesoflivertissue,34…     

人巨细胞病毒UL145基因在先天感染患儿临床株中的多态性研究

目的：研究人巨细胞病毒（HCMV）UL145序列在先天感染患儿临床株中的基因多态性，探讨HCMV基因多态性与先天感染引起的不同临床症状之间的关系。方法：对16株临床低传代分离株和15株未传代临床株的HCMV临床标本分别进行UL145全序列PCR扩增，对PCR扩增阳性的31例标本进行序列测定及分析，并且与9株已在GenBank递交的HCMVUL145序列进行比较分析。结果：序列分析结果表明31株HCMV临床株的UL145基因是高度保守的。所有临床株的HCMVUL145开放阅读框架均为393bp，编码蛋白含有130个氨基酸。所有临床株的核苷酸同源率为95．9％～100％，编码蛋白的同源率为97．7％～100％。临床症状不同的患儿其HCMVUL145基因及其编码蛋白具有相似的结构。所有先天感染患儿临床株的UL145编码蛋白具有蛋白激酶C（PKC）磷酸化功能位点和酪蛋白激酶（CK2）磷酸化功能位点。结论：HCMVUL145基因在临床株中是高度保守，未发现其与HCMV先天感染不同临床症状间存在明显的关系。HCMV UL145基因的高度保守性在先天感染中具有重要作用。     

MICA*008基因与人巨细胞病毒感染的相关性分析

目的 研究慢性粒细胞性白血病(CGL)MICA*008基因与HCMV感染的相关性.方法 应用PCR/SSP方法分别检测86例慢性粒细胞性白血病患者和81例无血缘关系的随机健康个体的MICA*008基因,同时用ELISA的方法分别检测随机健康个体和慢性粒细胞性白血病患者接受骨髓移植手术前、后外周血HCMV-IgM抗体.结果 ①CGL患者组MICA*008基因频率(22.2%)比对照组(34.3%)低(χ2=4.98,P＜0.05);②MICA*008基因阴性个体的HCMV感染率高于阳性个体的HCMV感染率(P＜0.05),MICA*008基因与HCMV感染关系呈中度相关(C=0.5829,0.6142).结论 MICA*008基因阳性个体对HCMV不易感,阴性个体对HCMV易感,即MICA*008基因与HCMV负相关.     

Cytomegalovirus infection in children’s liver tissues

Summary Immunoperoxidase histochemical assay with monoclonal antibody against human cytomaglovirus (HCMV) was used to detect immediate early antigen (IEA) and early antigen (EA) of HCMV infection in liver tissue of 72 pediatric cases (34 autopsies and 38 biopsies). The HCMV antigen was positive in 25 % (18/27). Among them, 12 cases were both HCMV-IEA and EA positive; 4 were HCMV-IEA positive and 2 HCMV-EA positive only. Liver HCMV infection rate in neonates, the infants with the age <1 year and >1 year was 8. 0 %, 60. 0 %, and 14. 8 %, respectively, indicating that liver HCMV infection occurred at various ages. The liver HCMV infection rate in different diseases was 50. 0 % in infantile hepatitis syndrome; 70. 0 % in extrabiliary malformation, and 12. 5 % in other hepatopathies, suggesting that infantile hepatitis syndrome and extrabiliary malformation were related with HCMV infection in liver tissues.     

EB病毒感染与婴儿肝炎综合征的临床研究

目的探讨EB病毒(EBV)感染在婴儿肝炎综合征(IHS)发病中的作用。方法选取45例HIS患儿为研究组,40例健康婴儿为对照组。采用ELISA法检测研究组和对照组血清EBV衣壳抗原(VCA)IgM抗体,采用PCR法检测研究组和对照组外周血单核细胞及咽分泌物中的EBV DNA,并进行比较分析。结果研究组45例患儿中有7例血清VCA-IgM抗体阳性,阳性率为15·6%;对照组40例婴儿血清VCA-IgM抗体均为阴性,两者间差异有统计学意义(P<0·05);研究组与对照组的外周血单核细胞EBV DNA的阳性率间差异有统计学意义(P<0·05),咽分泌物EBV DNA的阳性率间差异亦有统计学意义(P<0·01)。结论EBV感染是IHS的重要病因,由EBV感染导致的婴儿肝脏损害应引起临床高度重视。     

先天性巨细胞病毒、乙型肝炎病毒和弓形体感染的研究

对青岛市276例产妇及其新生儿脐血巨细胞病毒(HCMV)抗体,乙型肝炎病毒(HBV)标记物及弓形体抗体进行了检测。产妇HCMV感染率为98.91%,活动性感染率为18.48%;HBV感染率为39.13%;弓形体感染率仅为1.81%。HCMV,HBV和弓形体的先天性感染率分别为3.99%,2.17%和0。从新生儿出生时情况看,HCMV先天性感染所致危害远大于HBV和弓形体。     

Preliminary use of recombinant glycoprotein 52kd as an antigen in the diagnosis of human cytomegalovirus infection]

Interest in the human cytomegalovirus (HCMV) mainly derives from its associations with congenital malformations, mental retardation, and severe or fatal infections in immunosuppressed individuals such as transplant patients, tumor and AIDS patients. It is evidenced that there has been a need for a rapid and sensitive methods to detect an ongoing acute infection. The recent studies showed that high titers of antibody to the glycoprotein 52kd are present in sera of patients undergoing acute HCMV infection. However, purification of individual glycoprotein from HCMV-infected cells is a daunting prospect. HCMV glycoprotein 52 kd expressed via recombinant DNA techniques are a promising approach to solve this problem. In order to evaluate the diagnostic value of the recombinant glycoprotein 52 kd antigenic code region for HCMV infection, we have used the polymerase chain reaction (PCR) and recombinant DNA techniques to construct successfully the high-level expression plasmid pHCMV containing the HCMV GP-52 kd antigenic code region, with the predicted protein at levels up to 20% in total bacterial protein. The expressed protein was purified from SDS-PAGE, used as an antigen in Western-blot, and reacted with 12 cases of the positive sera, 4 cases of the negative sera, following by reaction with HRP-labelled horse IgG antibody against human. The results indicated that the approach we are using to detect antibody to HCMV acute infection are as sensitive as general serological methods such as ELISA, with the advantages of easy preparation of antigen with high quantity, and clinical practicability.     

肾移植患者人巨细胞病毒的检测

采用ＰＣＲ和ＥＬＩＳＡ方法对１１例肾移植者的巨细胞病毒（ＨＣＭＶ）感染情况进行了研究。在术前及术后的４周内，对其外周血及尿中病毒和血清中ＩｇＡ及ＩｇＭ抗体进行了连续检测。结果显示：有６例在移植后出现巨细胞病毒感染，感染率为５４％（６／１１）。血、尿中ＨＣＭＶＤＮＡ或ＨＣＭＶ抗体（ＩｇＡ或ＩｇＭ）阳性。提示：用ＰＣＲ和ＥＬＩＳＡ方法对肾移植病人的ＨＣＭＶ感染情况进行监测，对预防和治疗ＨＣＭＶ感染和提高肾移植的成功率有着重要的意义。