婴儿巨细胞病毒感染听力损伤及更昔洛韦的治疗作用

Hearing impairment in infants with cytomegalovirus infection and therapeutic effect of ganciclovir

目的研究巨细胞病毒(CMV)感染患儿的听力损伤情况,探讨更昔洛韦治疗婴儿CMV感染的疗效。方法将68例CMV感染婴儿分为治疗组(38例,加用更昔洛韦)与对照组(30例,仅用护肝利胆等对症治疗)。治疗前后进行尿CMV-DNA及脑干听觉诱发电位(BAEP)检测。结果治疗组治疗后尿CMV-DNA阴转率高于对照组(P<0.05)。BAEP测试:与对照组相比,治疗后除了Ⅲ-V波峰间期(IPL)外各波潜伏期(PL)及IPL均较前减少(P<0.05)。Ⅴ波听反应阈:治疗组治疗后听力损伤率(13.1%)低于对照组(26.6%)(P<0.05)。结论 BAEP检测可早期发现CMV感染患儿听力障碍的程度和性质。加用更昔洛韦治疗近期可减少尿中CMV排毒及消除病毒血症,远期可降低听力异常的发病率。

Objective To study the hearing impairment in infants with cytomegalovirus（CMV） infection and therapeutic effect of ganciclovir.Methods Sixty-eight cases with CMV infection were randomly divided into treatment group（group A,38 cases,treated with additional ganciclovir） and control group（group B,30 cases,treated with protecting liver gallbladder and other symptomatic treatment only）.Urine CMV-DNA and brain-stem auditory evoked potentials（BAEP） were detected before and after treatment.Results After the treatment,CMV-DNA negative rate was higher in group A than that in group B（P0.05）.The PL and IPL waves of BAEP,except IPL of Ⅲ-Ⅴ wave,were lower in group A than those in group B after therapy（P0.05）.Examination of wave V response threshold of hearing showed that the hearing impairment rate after therapy was lower in group A than that in group B （13.1% vs. 26.6%）（P0.05）.Conclusion BAEP examination is helpful to evaluate the degree and quality of hearing impairment in infants with CMV infection in the early stage.Combined use of ganciclovir can reduce the detoxification and urine elimination of CMV viremia in short-term and the incidence of abnormal hearing in long-term.