住院患儿TORCH感染状况

TORCH Infection in Pediatric Patients in Hospitalization

目的了解中国医科大学附属盛京医院住院患儿的TORCH感染状况及临床特点。方法对2007年10月-2008年3月本院儿科住院的1652例患儿,应用化学发光免疫分析法检测其血清TORCH-IgM。对巨细胞病毒抗体(CMV)-IgM阳性的患儿,采用荧光定量聚合酶链反应检测其尿液CMV DNA。并将患儿按年龄分为1～28d组、29d～6个月组、7个月～3岁组、4～10岁组,应用SPSS13.0分析软件进行数据分析,率的比较采用χ2检验,分析TORCH感染患儿的临床特点。结果1.各年龄组患儿TORCH-IgM总阳性率为14.10%(233/1652例)。其中弓形虫、风疹病毒、CMV、单纯疱疹病毒阳性率分别为0.73%、0.48%、8.90%、4.0%。11例患儿为2种病原体混合感染。147例CMV-IgM阳性的患儿中,135例患儿尿液中能够检测到CMVDNA,2种方法检测CMV的符合率为91.84%。2.新生儿组患儿TORCH-IgM总阳性率明显低于其他年龄组患儿,有显著性差异(Pa<0.01)。3.TORCH-IgM阳性患儿的临床表现不典型,其疾病类型主要为支气管肺炎、巨细胞病毒性肝炎、血小板减少性紫癜及癫癎、病毒性脑炎等疾病。结论住院患儿TORCH感染较常见,其中以CMV感染最为普遍。由于TORCH病原体感染多缺乏典型症状,应对住院患儿开展全面TORCH检测,避免单一检测引起漏诊。

Objective To study the situation of TORCH infection of pediatric patients in Shengjing hospital affiliated to China medical university and to analyze clinical features of patients with TORCH infection. Methods Chemiluminescent immunoassay was used to detect the TORCH - IgM in the serums of 1 652 patients in our hospital from Oct. 2007 to Mar. 2008. Urine cytomegalovirus（CMV） DNA in the children whose serum CMV - IgM was positive was detected by fluorescent quantitative polymerase chain reaction assay. The patients were divided to groups of 1 -28 days,29 days -6 months,7 months -3 years old and 4 - 10 years old,respectively. SPSS 13.0 software was chosen for the statistical ＂ 2 analysis,and X test was used for the prevalence comparison. The clinical features of patients with TORCH infection were analyzed. Results 1. There were 14.10% （233/1 652 cases） children with positive TORCH - IgM,in which positive rates of toxoplasma, rubella, CMV and herpes simplex virus were 0.73% ,0.48% ,8.90% and 4.0% ,respectively. CMV infection Was the most common,and HSV infection was next to it. Eleven children existed multiinfection of 2 pathogens. Urine CMV DNA of 135 children with positive serum CMV - IgM could be detected definitely, and the consistency rate of the 2 methods was 91.84%. 2. The positive rates of TORCH - IgM in newborn infants group were lower than those of children in other ages groups（ Pa 〈 0. 01 ）. 3. The clinical manifestations of patients with TORCH infection were atypical,and the major clinical diseases were pneumonia, hepatitis, thrombocytopenia and neurologic disease including epilepsy, encephalitis and so on. Conclusions TORCH infection was common in pediatric children in hospital, and major infection was CMV infection. Since the clinical manifestations of patients with TORCH infection were atypical, pediatric doctors should carry out overall TORCH detection, thus to avoid missing diagnosis due to a single detection.