晚发性维生素K缺乏与人类巨细胞病毒感染的临床关系分析

Late vitamin K deficiency and human cytomegalovirus infection in clinical analysis

目的探讨晚发性维生素K缺乏与人类巨细胞病毒(HCMV)感染的临床关系。方法对阜阳市人民医院儿科2008年1月到2010年12月收治11 768例患儿中的98例晚发性维生素K缺乏者,分为HCMV-IgM(+)组及HCMV-IgM(-)组,结合实验室检验结果及临床资料进行分析;并将同期住院的其他疾病母乳喂养儿98例作为对照组,测定HCMV-IgM。结果①98例中89例有颅内出血,8例有消化道出血,1例有脐部出血。经综合治疗,48例治愈,27例好转,15例放弃,8例死亡。经随访发现,共有31例留有不同程度神经系统后遗症。②39例HCMV-IgM(+)患儿中谷丙转氨酶增高、总胆红素增高、FIB降低的比率均较59例HCMV-IgM(-)患儿显著增高(P值分别为:0.000,0.000,0.015),差异有统计学意义。③98例患儿中HCMV-IgM(+)39例,同期住院的其他疾病母乳喂养儿98例中HCMV-IgM(+)7例,其阳性率比较差异具有统计学意义(P=0.000)。结论晚发性维生素K缺乏多表现为颅内出血,伤残率、病死率高,幸存者多留有不同程度的后遗症,与HCMV感染具有一定关系。

Objective To explore the late - onset vitamin K deficiency in the clinical relationship with human cytomegalovirus （ HC- MV） infection. Methods A total of 98 cases of late - onset vitamin K deficiency, who were treated in the Department of Pediatrics in Fuy- ang City Peopleb Hospital from January 2008 to December 2010, were divided into HCMV - IgM （ ＋ ） group and HCMV - IgM （ - ） group ; the results of laboratory testing and clinical data were combined for analysis ; during the same period of being hospitalized for other diseases, 98 cases of breastfeeding children were as control group, and HCMV - of IgM was determined. Results （1） Of the 98 cases, there were 89 cases of intracranial hemorrhage,8 cases of gastrointestinal bleeding, and one case of umbilical bleeding. After comprehensive treatment, 48 cases were cured, 27 cases improved, 15 cases gave up, 8 cases died. The follow- up found there were a total of 31 cases left with varying degrees of neurological sequelae. @Among the 39 cases of HCMV - IgM （ ＋ ）, total bilirubin, alanine aminotransferase increased, and FIB was reduced compared with 59 cases of HCMV - IgM （ - ）, and the differences were statistically significant. （ P values were 0.000, O. 000, and 0. 015 respectively）. （3） There were 39 children of HCMV - IgM （ ＋ ） in 98 cases, while 7 cases of HCMV - IgM （ ＋ ） in 98 breastfeeding children hospitalized in the same period with other diseases, and the positive rate difference was statistically significant （P=0.000）. Conclusion Late - onset vitamin K deficiency showed more performance for intracranial hemorrhage, the disability rate, high mortality, and the survivors are more left with varying degrees of sequelae, which has a certain relationship with HCMV infection.