婴儿肝炎综合征、胆道闭锁、胆总管囊肿与巨细胞病毒感染的关系

Relationship between human cytomegalovirus infection and three diseases including infantile hepatitis syndrome,biliary stresia,and choledochal cyst

目的:探讨人巨细胞病毒(HCMV)感染与婴儿肝炎综合征(IHS)、胆道闭锁、胆总管囊肿的关系．方法:采用ELISA法和免疫组化法对IHS患儿 98例、胆道闭锁患儿50例、胆总管囊肿患儿 50例血尿及其母亲血和乳汁进行检测,同时检测62例非肝胆疾病患儿及其母亲．结果:血CMV-IgM阳性率IHS组61．2％,其母亲33．7％;胆道闭锁组56．0％,其母亲36．0％; 胆总管囊肿组22．0%,其母亲6．0％．对照组阳性率22．6％,其母亲8．1％．患儿尿HCMV抗原阳性率HIS组71．4％,其母亲乳汁HCMV抗原 91．8％;胆道闭锁组62．0％,其母亲82．0％;胆总管囊肿组20．0％,其母亲54．0％．对照组阳性率24．2％,其母亲乳汁56．5％．IHS组及胆道闭锁组患儿及其母亲阳性率分别高于对照组患儿及其母亲(P<0．01),胆总管囊肿组患儿及其母亲阳性率均不高于对照组患儿及其母亲 (P>0．05)．结论:IHS及胆道闭锁的发病与HCMV感染有关,胆总管囊肿的发病与HCMV感染无明显相关性．

AIM： To explore the relationship between human cytomegalovirus （HCMV） infection and infantile hepatitis syndrome （IHS）, biliary atresia, and choledochal cyst. METHODS： The blood and urine samples from children with IHS （n= 98）, biliary atresia （n = 50） and choledochal cyst （n = 50）, and the blood and breast milk from their mothers were analyzed by enzyme-linked immunosorbent assay （ELISA）. Sixty-two subjects without hepatobiliary diseases and their mothers served as controls. RESULTS： The positive rates of blood CMV- IgM were 61.2% and 33.7% in IHS children and their mothers, 56.0% and 36.0% in biliary atresia children and their mothers, 22.0% and 6.0% in choledochal cyst children and their mothers, and 22.6% and 8.1% in the controls and their mothers, respectively. The positive rates of urine HCMV antigen were 71.4%, 62.0%, 20.0% and 24.2% in IHS, biliary atresia, and choledochal cyst, and control children, while the rates were 91.8%, 82.0%, 54.0% and 56.5%, respectively. The positive rates of CMV-IgM and HCMV antigen in HIS and biliary atresia group were higher than those in the controls （P 〈 0.01）, while the rates in choledochal cyst group had no significant differences with the controls （P 〉 0.05）. CONCLUSION： HCMV infection is associated with IHS and biliary atresia, but not with choledochal cyst.