人巨细胞病毒感染母婴传播与母乳喂养

Mother-to-child HCMV Transmission and Breast-feeding

目的探讨人巨细胞病毒(HCMV)母婴传播中的母乳喂养与婴儿HCMV感染的关系,进而指导感染人巨细胞病毒母乳对婴儿的合理喂养。方法应用荧光定量聚合酶链反应(FQ-PCR)方法分别检测113对临床疑诊HCMV感染患儿及其母亲HCMV-DNA含量,用免疫荧光法检测患儿血HCMV-PP65抗原。结果母乳HCMV-DNA与配对患儿血HCMV-PP65抗原两者之间有关联(χ2=6.48,0.01<P<0.025),但关系不是非常密切,阳性母乳配对患儿与阴性母乳配对患儿的血HCMV-DNA之间差异无统计学意义(t=1.432,P>0.05)。结论母乳HCMV感染是婴儿获得HCMV感染的重要途径,但是二者关联性不强,故对已感染HCMV的患儿建议母乳喂养,对母亲HCMV阳性,而婴儿HCMV阴性的可将乳汁处理后喂养,更加安全。

Objective To approach the relationship between breast-feeding and baby's human cytomegalovirus(HCMV) infection through the mother-to-child HCMV transmission,so as to provide guidance on baby feeding for mothers with HCMV infection. Methods HCMV-DNA content was detected by fluorescence quantitation PCR(FQ-PCR) in 113 pairs of children and mothers with clinically suspected HCMV infection.Serotype HCMV-PP65 antigen was determined by immunofluorescence.The results were statistically analyzed by χ2 test and t-test. Results The HCMV-DNA in breast milk was significantly correlated with the serotype HCMV-PP65 antigen in the paired HCMV child(χ2=6.48,P<0.05),but was not closely correlated.The serum HCMV-DNA content did not show any significant difference between the HCMV-DNA-positive breast milk paired patient and the HCMV-DNA-negative breast milk paired patient(t=1.432,P>0.05). Conclusions HCMV-seropositive breast milk is a major approach for baby to get infected with HCMV.Nevertheless,they do not strongly correlated. So breast-feeding is suggested for children with HCMV infection,while it is safer to process the breast milk from HCMV-seropositive mothers before feeding HCMV-seronegative children.