成人巨细胞病毒感染54例临床分析

Clinical Analysis of Cytomegalovirus Infection in 54 Adults

对５４例成人巨细胞病毒（ＣＭＶ）感染分３组进行临床分析。（１）ＣＭＶ单核细胞增多症；以发热明显而症状消遥，一过性肝功能损害，血液学改变类似传染性单核细胞增多症而ＥＢ病毒指标阴性为特征。并发症复杂但预后好。（２）ＣＭＶ肝炎：临床表现与其他病毒性肝炎相似。以急性黄疸型恢复最快，单纯转氨酶升高次之，无黄疸型较慢。单纯ＣＭＶ肝炎预后好。（３）免疫缺损者ＣＭＶ感染；７５％病例于免疫抑制治疗后发病。体温高，并发症凶险，半数病人死亡。建议对不明原因高热、肝炎、肺炎，特别是免疫缺损者，要考虑ＣＭＶ感染的可能。

Fifty-four cases,subdivided into 3 forms,of cytomegalovirus(CMV)infection in adults were analyzed0.(1)CMV mononucleosis:It typically had hyperpyrexia with mild symptoms.Transient abnormal liver functions and infectious-monocucleosis-like hematologic features with a negative EB virus marker were noted.Though its complications were complex,its prognosis was satisfactory.(2)Hepatitis caused by CMV:The clinical features might be simiiar to those of other viral hepatitis.Of all types,the acute icteric hepatitis recovered the quickest,much quicker than hepatitis with single rise of AIT. The non-icteric type recovered the slowest.The prognosis of pure CMV hepatitis was usually good.(3)CMV infections in immunuo-compromized patiens:75%of the cases were infected after immunosuppressive therapy.They usually had hyperpyrexia with fatal complications.Half of the cases usually died of the illness.The authors suggest that a physician should bear in mind the possibility of CMV infection in patients with hyperpyrexia,hepatitis or pneumonia of unknown origin,particularly in immuno-compromized cases.