先天性TORCH感染的治疗预后探讨

TO EXPLORE THE TREATMENT AND PROGNOSIS OF CONGENITAL TORCH INFECTIONS

目的 探讨先天性TORCH感染的预后,提出防治措施。方法 对51例确诊HCMV、HSV、EBV、TOXO感染—甲组(各31、6、1及13例)分别采用α-干扰素(α-IFN)加静脉用人体免疫球蛋白(IVIG)治疗或用螺旋霉素及阿奇霉素治疗。另选30例足月正常新生儿为对照Z组。随访体格、神经系统发育。结果 治疗结束后3或6个月复查血清相关TORCH IgM IgG或/和FQ DNA PCR均转阴性。甲组体格发育明显低于正常儿,精神及运动发育各低于乙组22分及21分。小头、智力低下、脑瘫各为9,19,17例。结论 所述疗法对先天性HCMV,HSV,TOXO感染是有效而安全的。血清相关TORCH抗体及FQ DNA PCR治疗后转阴性,但不能完全修复宫内已形成的脑损伤及发育落后。

To study the treatment, prognosis and approach the prophyaxis Of congenital TORCH infections as early as possible. Methods 1. Divided groups: there were 51 cases with congenital TORCH infection in neonatal period(group A) and 30 normal full-term infants as control(group B). In 51 cases, 31 infected cases with HCMV, 6 infected with HSV, and 1 cases with EBV. They were treated by α-Interferon (α-IFN) and IVIG; 13 cases with TOXO infection were treated by spiromycin and az- ithromycin. All were followed-up and intervened. Physical and neurological examination and intelli- gence test CDCC were made during follow-up, (226±113) days. Results ①3 or 6 months after the therapy, the blood serum examination of CMV, HSV, EBV and TOX IgM, IgG or/and FQ DNA PCR be- came negaive except 2 cases of HSV IgG were still positive.②Physical development: Group A were de- layed than control group(p < 0. 0l ).③Intelligence development: MDI and PDI were higher in control group, 22 and 21 score respectively.④In group A, 19 infants had low MDI, MDI<69, 17 infants suf- fered from cerebral palsy. Conclusions α-IFN and IVIG was effective therapy in HCMV, HSV and EBV infections. Spiramycin and Azithromycin were safty therapy for TOXO infection. The patients should be followed up and early intervention is necessary.