尿CMV快速培养在胆道闭锁患儿诊治中的作用

目的调查我科收治的胆道闭锁(biliary atresia,BA)患儿巨细胞病毒(cy-tomegalovirus,CMV)感染率并探讨尿CMV快速培养在BA患儿诊治中的作用。方法对21例BA患儿血清CMV-IgM、CMV-IgG及尿CMV快速培养结果进行总结,同时采用Masson染色法检测患儿肝纤维化程度;根据尿CMV检测结果进行分组,比较两组患儿肝功能、肝纤维化程度及胆汁排出率的差别。结果BA患儿尿CMV快速培养阳性率为57.1%,高于血清CMV-IgM检测结果;尿CMV阳性组患儿肝功能及肝纤维化程度明显高于尿CMV阴性组,而术后胆汁排出率低于尿CMV阴性组。结论BA发生与CMV感染相关;尿CMV快速培养可用于诊断BA患儿CMV活动性感染;伴有CMV活动性感染的BA患儿肝损伤及肝纤维化程度均较严重,应尽早手术。

Role of shell vial assay in the diagnosis and treatment of biliary atresia

Objective To investigate the infection ratio of cytomegalovirus in biliary atresia(BA) children in our department and discuss the significance of shell vial assay in the diagnosis and treatment of BA children.Methods Twenty-one BA children from our department were involved in this experiment.Anti-CMV IgG and IgM in serum were detected by ELISA,the CMV immediate early antigen(IEA) in urine by shell viral assay and the degrees of liver fibrosis were evaluated by Masson staining.Children were classified into CMV positive group and CMV negative group based on the results of shell viral assay.The biochemical indicators,hepatic fibrosis degrees and bile exhaust rates of these two groups were compared respectively.Results The positive ratio of shell viral assay in urine active CMV of BA children was 57.1%,which was significantly higher than the ratio of CMV IgM in serum.The biochemical indicators and hepatic fibrosis degrees were significantly increased in CMV positive group,but the bile exhaust ratio was reduced as compared with those in CMV negative group.Conclusion The high active CMV infection ratio of BA children in this experiment supported a close relationship between the occurrence of BA and the infection of CMV.Shell viral assay can be used to diagnose active CMV infection in BA children.Those BA children who accompany with active CMV infection have more severity of hepatic injury and fibrosis,so they should be operated early.