巨细胞病毒感染引起听力损害的相关因素分析

目的 探讨引起巨细胞病毒(CMV)感染患儿听力损害的相关因素分析。方法 依据脑干听觉诱发电位(BAEP)检测结果将158 例CMV 感染患儿分为听力正常组(n=117,BAEP ≤ 35)和听力异常组(n=41,BAEP>35)。收集两组患儿一般资料、血常规、肝功能、尿液及乳汁病毒拷贝数等进行回顾性分析;绘制受试者工作特征曲线(ROC)预测导致BAEP 异常的CMV-DNA 病毒载量;采用Spearman 秩相关分析对尿CMV-DNA拷贝数与听力损害程度、血小板计数间进行相关性分析。结果 听力异常组血小板异常率、肝功能异常率和尿CMV-DNA 拷贝数均高于听力正常组(P<0.01)。ROC 分析结果显示,当尿CMV-DNA 拷贝数为1.415×10⁶/mL时,预测病毒载量导致听力损伤的敏感性为46.3%,特异性为93.2%。相关性分析结果显示,听力损害的程度随着CMV-DNA 拷贝数的增加而增高(r=0.382,P<0.01);血小板计数和尿CMV-DNA 拷贝数之间存在负相关(r=-0.233,P=0.003)。结论 尿CMV-DNA 病毒载量可能与CMV 感染导致神经性听力障碍相关;当CMVDNA载量达到1.415×10⁶/mL 时,更易出现听力损害。存在血小板减少的CMV 感染患儿,应加强听力监测。

Risk factors for hearing impairment induced by cytomegalovirus infection

Objective To investigate the risk factors for hearing impairment induced by cytomegalovirus (CMV) infection in children. Methods One hundred and fifty-eight children diagnosed with CMV infection were enrolled as subjects. Based on the results of the brainstem auditory evoked potential (BAEP) test, patients were classified into normal hearing group (n=117; BAEP ≤35) and abnormal hearing group (n=41; BAEP >35). A retrospective analysis was performed on the general information, routine blood indices, liver function, copy number of CMV-DNA in urine and breast milk. The receiver operating characteristic (ROC) curve was used to predict the copy number of CMV-DNA resulting in abnormal BAEP. The Spearman rank correlation analysis was used to test the correlations of the copy number of CMV-DNA in urine with the degree of hearing impairment and platelet count. Results The incidence rates of platelet abnormality and abnormal liver function and the copy number of CMV-DNA in urine were significantly higher in the abnormal hearing group than in the normal hearing group (P6 per mL. The results of correlation analysis showed that the degree of hearing impairment was positively correlated with the copy number of CMV-DNA (r=0.382, Pr=-0.233, P=0.003). Conclusions An increased copy number of CMV-DNA in urine might be a risk factor for hearing impairment induced by CMV infection. Children are likely to have hearing impairment when the copy number of CMV-DNA reaches 1.415×106 per mL. The monitoring of hearing should be strengthened in CMV-infected children with a decreased platelet count.