病理性黄疸新生儿巨细胞病毒感染的临床研究

目的 分析病理性黄疸患儿巨细胞病毒(CMV)感染情况,探讨母乳CMV-DNA检测的临床意义。方法 选取庆阳市人民医院住院的病理性黄疸新生儿300例,用FQ-PCR方法检测患儿血浆、外周血单个核细胞(PBMC)、尿液和母乳的CMV-DNA,ELISA法检测患儿血清CMV-IgM和IgG,分析CMV感染患儿的临床数据。结果 300例病理性黄疸新生儿中,CMV感染的阳性率为13.33%(40例),其中患儿血清CMV-IgM阳性率为4.33%(13例),CMV-IgG阳性率为80.85%(228例)。母乳CMV-DNA阳性率为46.00%(138例),患儿血浆CMV-DNA阳性率为4.00%(12例),PBMC CMV-DNA阳性率为6.67%(20例),患儿尿液CMV-DNA阳性率为10.00%(30例)。患儿尿液CMV-DNA的阳性率与乳汁CMV-DNA的阳性率有显著相关性(P<0.01)。40例CMV感染患儿中,婴儿肝炎综合症为13例(32.50%),新生儿肺炎12例(30.00%),缺血缺氧性脑病6例(15.00%),听力损伤5例(12.50%),腹股沟斜疝2例(5.00%)。结论 CMV感染是新生儿病理性黄疸主要原因之一;检测产妇母乳中CMV-DNA对母乳喂养具有临床指导意义,有助于预防CMV感染。

Clinical analysis of Cytomegalovirus infection in neonates with pathological jaundice

ObjectiveCytomegalovirus (CMV) infection in children with pathological jaundice was analyzed, and to explore the significance of breast milk CMV-DNA test. MethodsThree hundred neonatal cases with pathological jaundice hospitalized in Qingyang People's Hospital were selected. CMV-DNA of plasma, PBMC, urine and breast milk were detected by FQ-PCR, and serum CMV-IgM and IgG were detected by ELISA, and clinical data of children with CMV infection were analyzed. Results Among the 300 neonates with pathological jaundice, the positive rate of CMV was 13.33%(40 cases), among which the positive rate of serum CMV-IgM was 4.33%(13 cases) and the positive rate of CMV-IgG was 80.85%(228 cases). The positive rate of CMV-DNA was 46.00%(138 cases) in breast milk, 4.00%(12 cases) in plasma, 6.67%(20 cases) in PBMC, and 10.00%(30 cases) in urine. The positive rate of urine CMV-DNA was significantly correlated with that of breast milk (P<0.01). Among the 40 cases with CMV infection, infantile hepatitis syndrome was 13 cases (32.50%), neonatal pneumonia was 12 (30.00%), hypoxic ischemic encephalopathy was 6 (15.00%) , hearing impairment was 5(12.50%) , and indirect inguinal hernia was 2 (5.00%). Conclusion CMV infection is one of the main causes of neonatal pathological jaundice. The detection of breast milk CMV-DNA has clinical significance for breastfeeding to prevent CMV infection.