先天性巨细胞病毒感染对婴幼儿听力及智力影响的研究

目的　探讨先天性巨细胞病毒 (CMV)感染对婴幼儿生长发育、听力及智力的影响。方法　对 65例先天性CMV感染儿及 82例非感染儿于新生儿期进行生长发育及听力的检测 ,并于生后 6个月至 4岁进行随访。随访内容包括 :体格检查、发育商测试及听力测试。结果　两组生长发育状况无显著性差异。感染组发育商落后8例 ,对照组仅 1例 ,二者有显著性差异。感染组新生儿期、随访时分别有 7例 9耳、9例 11耳未通过TEOAE听力测试 ,对照组均为 1例 1耳未通过 ,未通过率感染组明显高于对照组。新生儿期、随访时双耳反应能量感染组明显低于对照组。 14例进行了ABR检测 (感染组 12例 ,对照组 2例 ) ,其中感染组 9例 17耳听力异常 ,对照组 1例 1耳听力异常。结论　先天性CMV感染对婴幼儿生长发育可能无明显影响 ,但对听力、智力的损害却不容忽视     

先天性巨细胞病毒感染对婴幼儿的影响

为探讨先天性巨细胞病毒(CMV)感染对婴幼儿的影响，采用瞬态诱发性耳声发射(TEOAE)对65例先天性CMV感染儿及82例非感染儿于新生儿期进行听力筛查，并于生后6个月至4岁进行听力及智力随访。感染组发育商落后8例，对照组仅1例，二组差异显著。感染组新生儿期、随访时分别有7例9耳、9例ll耳未通过TEOAE听力测试，对照组均为1例1耳未通过，未通过率感染组明显高于对照组。新生儿期、随访时双耳反应能量感染组明显低于对照组。14例进行了脑干听觉诱发电位(ABR)检测，感染组9例17耳听力异常，对照组1例1耳听力异常。提示先天性CMV感染对听力、智力的影响应引起长期关注。     

先天性巨细胞病毒感染1例

患儿 ,男 ,2h ,因生后面部发绀 2h入院。G1P1,胎龄 38周 ,臀位剖宫产分娩。Apgar评分不详。无家族特殊病史。查体 :体温 36℃ ,脉搏 16 0次 /min ,呼吸 6 0次 /min ,体重 2 .7kg,身长 4 5cm ,头围 32 .5cm。面部发绀 ,呼吸急促 ,双肺呼吸音粗。心率 15 6次 /min ,心音有力 ,律齐 ,各瓣膜听诊区未闻及杂音。腹部膨隆 ,肝右肋下 4 .5cm ,剑突下 4 .0cm ,质稍韧。脾左肋下 4 .0cm ,质稍韧。双侧阴囊水肿 ,双侧腹股沟区见可复性包块。四肢短小。入院d2出现黄疸 ,且迅速加深并遍及全身 ,色暗黄。体温 4 0℃ ,呈稽留热。全身皮肤散在出血点。大…     

先天性巨细胞病毒感染的临床研究

目的：　探讨先天性巨细胞病毒感染对胎儿、新生儿、婴儿的影响。方法：　分析了98例母孕期感染巨细胞病毒所产下的新生儿,其中48例为先天性巨细胞病毒感染儿(感染组),50例为非感染儿(对照组),对比研究两组围产期的合并症和临床疾病情况。结果：　感染组先兆流产的发生率是16.7% (8/ 4 8),对照组先兆流产的发生率是4%(2 / 50 ),差异有显著性意义,(χ2 =4.2 9,P<0.05)。感染组有新生儿黄疸18例,对照组有15例,两组差异无显著性意义。感染组发生CMV肝炎3例、血小板减少1例、小头畸形1例、脑瘫1例、癫痫1例。且有3例新生儿黄疸发生CMV肝炎,2例CMV肝炎出现肝硬化。结论：　先天性巨细胞病毒感染可引起胎儿先兆流产。黄疸不是新生儿先天性巨细胞病毒感染的特征性症状,但表现黄疸的先天性巨细胞病毒感染新生儿可能会发生CMV肝炎,且预后不良。在先天性巨细胞病毒感染中,中枢神经系统容易累及     

围生期和出生后巨细胞病毒感染对婴儿生长发育及智力的影响

目的 探讨围生期和出生后巨细胞病毒(CMV)感染对婴儿生长发育及神经心理发育的影响.方法 对48例围生期和生后CMV感染及22例非CMV感染的婴儿进行随访观察,对比两组出生、3月龄及1岁龄时体格发育变化,并分别对两组1岁龄婴儿进行发育商(DQ)测试.结果 出生及3月龄时两组婴儿的身长、体质量、头围比较差异无显著性(P>0.05),1岁龄时身长、体质量、头围均值均在正常范围,感染组与非感染组比较差异均无显著性(P>0.05).两组1岁龄时大运动、精细运动、适应性、语言、社交能力DQ比较差异均无显著性(P>0.05),总DQ均值在正常范围,两组亦无显著性差异(P>0.05).两组DQ值按评价等级划分,大都处于正常级别范围,差异亦无显著性(χ2=1.026,P>0.05).结论 围生期和出生后CMV感染对婴儿近期的生长发育及神经心理发育没有明显的不良影响.     

巨细胞病毒感染与婴幼儿脑损伤的关系

巨细胞病毒感染与婴幼儿脑损伤的关系湖南医科大学湘雅医院儿科（４１０００８）黄榕，杨于嘉，宋建辉，陶永光本研究用ＣＭＶ－ＤＮＡＰＣＲ的方法检测巨细胞病毒（ＣＭＶ）感染，并结合头部ＣＴ检查，以了解婴幼儿损伤与ＣＭＶ之间的关系，为小儿脑损伤的病因学研究提供...     

先天性无症状性巨细胞病毒感染对婴儿期发育的影响

目的 通过对先天性无症状性巨细胞病毒(HCMV)感染的新生儿进行系统随访,观察其听力学、体格发育、智能发育、行为发育等多方面的改变,探讨先天性无症状性HCMV感染对婴儿期发育的影响.方法 按照1998年宜昌会议通过的<巨细胞病毒感染诊断方案>标准及美国Fowler标准确定先天性无症状性巨细胞病毒感染.2003年7月至2005年7月符合人选条件感染病例41例,对照组21例.进行静脉血荧光定量PCR(FQ-PcR)检测确定HCMV感染.感染组与对照组于新生儿期、3月龄、6月龄、1岁分别进行新生儿20项行为神经检查(NBNA)、听力学检查包括耳声发射听力检查(OAE)、听力脑干诱发电位检查(ABR)、Bayley婴幼儿发育量表评估发育智商、52项运动神经检查(Amid-Tison法)和体格发育检查、一般状况检查.结果 (1)两组新生儿12～14 d时加项NBNA得分分别为38.8±2.75和38.5±2.29,差异无统计学意义(t=0.98,P＞0.05).(2)ABR检查:感染组中23例做ABR检查者V波阈值升高异常率为15.2%;对照组21例未发现V波阈值升高,差异有统计学意义,所有病例均通过OAE检查.(3)感染组中38例1岁时行Bayley婴幼儿发育量表检查智力发育指数(MDI)及精神运动发育指数(PDI)分别为106.86±10.24和108.45±18.25,与对照组2l例(107.49±19.31和107.19±10.98)差异亦无统计学意义(t=0.33,P＞0.05,t=0.35,P＞0.05).(4)52项运动神经发育:两组比较,差异无统计学意义(t=0.02,P＞0.05).结论 (1)先天性无症状HCMV感染在婴儿期即可出现脑干听性反应V波阈值升高,而OAE听力筛查未能检出异常.(2)先天性无症状性HCMV感染对新生儿期行为神经、婴儿期智力、婴儿期神经运动发育无明显影响.     

先天性肾积水与巨细胞病毒感染的关系

应用聚合酶链反应技术检测２３例先天性肾积水患儿肾盂内尿液和狭窄段组织块人巨细胞病毒ＤＮＡ，以及血清间接免疫荧光试验法检测巨细胞病毒。结果：６例肾盂内尿液、８例狭窄段组织块和８例血清标本为阳性；对照组６例，仅１例尿液为阳性（Ｐ＜０．０５）。提示光天性肾积水可能与巨细胞病毒感染有关。     

婴儿巨细胞病毒感染致听力受损的研究进展

巨细胞病毒(CMV)感染分布广泛,人类是其惟一宿主,CMV可致部分婴儿(主要是宫内感染及围生期感染儿)发生感觉神经性耳聋.目前,该类患儿听力受损的特点、治疗及预后越来越受到临床医师的关注.该文对婴儿CMV感染时听力受损的发生时间、发生率、特点及治疗等进行综述.     

先天性巨细胞病毒感染误诊3例分析

巨细胞病毒(cMV)是先天性感染最常见的病毒,先天性CMV感染因其引起急性症状、死亡及后遗中枢神经系统、听力障碍而日益受到临床医师的关注.由于感染后的新生儿临床表现无特异性,单凭临床无法确诊,而实验室检测有一定的局限性,致使临床误诊、漏诊并非罕见.为总结经验、提高对该病的认识,特将临床误诊、尸解证实的先天性CMV感染3例报告如下.     

先天性巨细胞病毒感染研究进展

人类巨细胞病毒 (HCMV)是宫内病毒感染最常见的原因 ,先天性HCMV感染率很高是因为原发感染或再次感染的孕妇可以将病毒传给胎儿。先天性HCMV感染的胎儿各种器官、各种细胞均可能受累及 ,因此临床表现多样。先天性HCMV感染的产前诊断包括 :取胎儿血液或羊水做HCMV培养、HCMVIgM、HCMV抗原、HCMVDNA和胎儿血抗热休克蛋白IgM检测。无临床表现的先天性HCMV感染的胎儿 ,HCMVIgM抗体水平低 ;低病毒含量亦与无症状性感染有关。为了减少先天性HCMV感染性疾病 ,疫苗的应用似乎是一种有效方法。更昔洛韦治疗先天性HCMV感染有一定的作用     

母乳喂养对人巨细胞病毒感染婴儿免疫功能的影响

目的 探究母乳喂养对人巨细胞病毒(human cytomegalovirus,HCMV)感染患儿免疫功能的影响。方法 回顾性分析2021年1月—2022年5月郑州大学附属儿童医院收治的135例喂养方式为母乳喂养的HCMV感染患儿的病例资料,根据母乳HCMV-DNA检测结果分为母乳阳性组(78例)和母乳阴性组(57例),再根据母乳HCMV-DNA载量中位数,将母乳阳性组患儿分为母乳高病毒载量亚组(39例)和母乳低病毒载量亚组(39例),分别比较母乳阳性组和母乳阴性组、母乳高病毒载量亚组和母乳低病毒载量亚组患儿外周血淋巴细胞亚群CD3⁺T、CD3⁺CD4⁺T、CD3⁺CD8⁺T、CD19⁺B百分率,CD4⁺T/CD8⁺T比值,IgG、IgM、IgA及尿液HCMV-DNA载量。结果 母乳阳性组和母乳阴性组、母乳高病毒载量亚组和母乳低病毒载量亚组患儿在CD3⁺T、CD3⁺CD4...     

Ganciclovir therapy for congenital cytomegalovirus infection in six infants

BACKGROUND: Congenital cytomegalovirus (CMV) infection is common, and its morbidity rate is high. Ganciclovir (GCV) treatment has been used for congenital CMV infection, but there are few reports on viral loads associated with GCV therapy. METHODS: A real-time PCR assay was used to monitor viral load in 6 cases of symptomatic CMV infection that received GCV therapy. Initially GCV was given at a dose of 5-12 mg/kg/d for 2-7 weeks. In 2 cases, additional doses were given as symptoms returned. RESULTS: After GCV administration, active signs of chorioretinitis, thrombocytopenia and anemia disappeared or improved in all cases. During GCV therapy, viral loads decreased while patients improved clinically and increased again when GCV therapy was stopped. Although CMV DNA continued to be detectable for a long period, clinical findings did not always worsen. In 2 cases, an improvement of hearing loss was observed. CONCLUSION: GCV therapy transiently suppresses the CMV concentrations. Subsequent increases of viral titers do not appear to be correlated with the clinical course or neurologic outcome.     

Progressive hearing loss in infants with asymptomatic congenital cytomegalovirus infection.

Congenital cytomegalovirus (CMV) infection is a major public health problem because 30,000 to 40,000 neonates with the infection are born each year in the United States. Although 90% of the congenitally infected infants are asymptomatic at birth, evidence is accumulating that these infants are at risk for audiologic, neurologic, and developmental sequelae. The current study describes the audiologic outcome of 59 infants with asymptomatic congenital CMV infection compared with 26 control infants. Eight of 59 infected infants had congenital sensorineural hearing loss (SNHL) but none of the control subjects did. Longitudinal audiologic assessments revealed that 5 of the 8 infants had further deterioration of their SNHL; a ninth infant with initially normal hearing experienced a unilateral SNHL during the first year of life, with further deterioration subsequently. The frequency of SNHL was similar for infected infants born to mothers with recurrent CMV infections during pregnancy (2 of 9) and for those born to mothers who experienced primary CMV infections (5 of 26). There was a significant difference between the occurrence of hearing loss in infected infants with normal computed tomographic scans (2 of 40) compared with those with either periventricular radiolucencies (4 of 13) or calcifications (1 of 3). Children with SNHL often have no identified cause of the loss; thus, it is likely that many of these children had asymptomatic congenital CMV infection. Given the progressive nature of SNHL associated with asymptomatic congenital CMV infection, longitudinal audiologic assessments are mandatory.     

Glycoprotein B genotyping in congenital/perinatal cytomegalovirus infection in symptomatic infants

Background

Molecular epidemiological studies on circulating strains of CMV in cogenital/perinatal infections have not been done earlier in this region.

Objective

To study the glycoprotein B genotypes in babies with symptomatic congenital/perinatal CMV infection and to assess the possible influence of genotype on the outcome of the infection.

Methods

Clinical samples (blood and urine) of symptomatic babies are sent to the Virology Department of NCDC, Delhi for the diagnosis of congenital infections. 375 clinical samples of infants (newborn — 6 months old) were included for the study. Serum samples were subjected to ELISA for detection of IgM antibodies against CMV. DNA isolation and amplification of CMV genomic DNA targeting gB gene fragment by nested PCR, was carried out in the samples. The amplified fragment including the cleavage site was subjected to RFLP using restriction enzymes Rsal and Hinf1. They were also verified by sequencing using Big Dye Terminator chemistry.

Results

75 samples out of 375 tested were confirmed positive for CMV infection by serology and PCR. Both RFLP and sequencing of gB gene fragment showed that gB 1, 2 and 3 genotypes were in circulation. gB 3 was the most prevalent genotype in symptomatic infants. Hepatosplenomegaly was the most common feature in gB-3 genotype of CMV. gB2 congenital CMV infection was more commonly associated with long term sequelae.     

先天性人巨细胞病毒感染对乙肝疫苗免疫效果的影响

目的探讨先天性人巨细胞病毒(HCMV)感染对乙型肝炎(乙肝)疫苗免疫效果的影响。方法孕鼠腹腔注射HCMV悬液,以其子鼠为先天性HCMV感染模型,以健康大鼠的子鼠作为对照组。各组子鼠分别于生后1、3、5周接种乙肝疫苗,并于3、5、7、11周心脏采血,应用酶联免疫分析法检测各组子鼠血清乙肝表面抗体(HBsAb)滴度。结果随接种次数增加,两组子鼠血清HBsAb滴度均呈逐渐增加趋势,接种完成后随时间延长又有不同程度下降,两组子鼠血清HBsAb滴度随时间变化的差异均有统计学意义(P均0.001)。在各个时间点(3、5、7、11周),先天性HCMV感染组子鼠的血清HBsAb滴度均低于对照组,差异有统计学意义(P均0.01)。结论先天性HCMV感染可减弱乙肝疫苗免疫效果。     

Detection of congenital cytomegalovirus infection in Chinese newborn infants using polymerase chain reaction

Polymerase chain reaction (PCR) amplification was used to detect cytomegalovirus (CMV) in 1000 urine specimens from Chinese newborns for defining the incidence of congenital CMV infection in the Chinese population. The major immediate-early and the late antigen genes of CMV were amplified and detected by gel electrophoresis. There were 18 congenitally infected infants found when tests were performed with one or both primer pairs. Comparing with tissue culture, PCR of both primer sets provided a sensitivity of 94%, a specificity of 100% and a predictive value of positive result of 100%.     

Asymptomatic congenital cytomegalovirus infection]

Congenital cytomegalovirus infection occurs in about 1% of live births. Although 10% of these develop severe central nervous system impairment, the remainder have asymptomatic infection. However among the asymptomatic, 10% have some problems, mainly neurosensory hearing loss. The case of an infant affected by cytomegalovirus infection who developed neurological signs and impairment in auditory brain stem response is described.