对血浆HCMV-IgM、尿HCMV-DNA阳性患儿用更昔洛韦干预意义

The intervenient significance with ganciclovir on babies with positive result about plasma HCMV-IgM and urine HCMV-DNA

目的:调查对巨细胞病毒感染婴儿用更昔洛韦治疗的必要性。方法:本研究对2007年10月～2008年10月在深圳市宝安区妇幼保健院住院的0～6个月龄婴儿2840例,以ELISA法及PCR技术对患儿血浆HCMV-IgM、患儿尿及其母乳汁HCMV-DNA进行了检测,并对结果阳性及有临床症状的患儿分治疗组及对照组,治疗组采用更昔洛韦为主的综合治疗,对照组主要采取对症治疗,并判断疗效。结果:2840例患婴中血浆HCMV-IgM阳性者184例,占6.478%,尿HCMV-DNA升高者180例,占血浆HCMV-IgM阳性者97.8%,其母乳汁HCMV-DNA升高者170例,占血浆HCMV-IgM阳性者92.4%,对血清HCMV-IgM阳性、尿及其母乳汁HCMV-DNA升高的患儿分治疗组45例及对照组125例,发现治疗组临床症状改善42例(占93.3%),尿HCMV-DNA滴度降低30例(占66.7%),血浆HCMV-IgM转阴22例(占48.9%)。对照组临床症状改善80例(占64%),尿HCMV-DNA滴度降低10例(占8%),血浆HCMV-IgM转阴2例(占1.6%)。结论:采用更昔洛韦为主的综合治疗与采取单纯对症治疗相比,差异具有统计学意义,P<0.01。

Objective： To investigate the curing necessity with ganciclovir on babies infected by cytomegalovirus. Methods： 2 840 babies who hospitalized in the pediatric department of Bao＇an Maternal and Child Health Care Hospital from October, 2007 to October, 2008 were checked with the plasma HCMV-IgM, HCMV-DNA from urine and breast milk of their mothers respectively with the technic named ELISA and PCR. The positive cases with clinical symptoms were divided into curing group and controlling group, combined treatment with the main drug ganciclovir on the former while expectant treatment were taken on the latter. After that, the results were compared. Results： There were 184 positve results with plasma HCMV-IgM （occupying 6.478% in 2 840 cases）, 180 positve results with urine HCMV-DNA （occupying 97.8% in 184 cases）, while 170 positve results with breast milk HCMV-DNA （occupying 92.4% in 184 cases）. 170 positive cases were divided into two groups, curing group with 45 cases and controlling group with 125 cases. It was found that 42 cases were better with their clinical symptoms （occupying 93.3%）,30 got lower level with the urine HCMV-DNA （occupying 66.7%）, and 22 babies became negative with their plasma HCMV-IgM （occupying 48.9%） in the curing group. While 80 cases were better with their clinical symptoms （occupying 64%）, 10 got lower level with the urine HCMV-DNA （occupying 8%）, and 2 babies became negative with their plasma HCMV-IgM （occupying 1.6%） in the controlling group. Conclusion：There is statistics significance in the differences between the curing group under the combined treatment with the main drug ganciclovir and the controlling group under expectant treatment（P〈0.01 ）.