浙江省温州地区住院患儿人巨细胞病毒感染状况分析

Prevalence of human cytomegalovirus infection in hospitalized children in Wenzhou

目的分析温州地区住院患儿人巨细胞病毒(HCMV)感染状况及血清标志物的分布特点。方法收集2010年3月至2011年2月期间5 215例温州地区住院患儿,按年龄将患儿分为<28d、28～d、6～月龄、1～岁、3～岁、7～14岁6个组,采用化学发光法(chemiluminescence immunoassay,CLIA)定量检测血清HCMV IgM/IgG抗体浓度,并对各年龄段HCMV IgM/IgG的阳性检出率及抗体水平进行分析。结果 5 215例住院患儿HCMV IgM阳性检出率为14.38%(750/5 215),HCMV IgG阳性检出率为82.45%(4 300/5 215),HCMV IgM和HCMV IgG同时为阳性12.98%(677/5 215);HCMV IgM阳性检出率以<28d组最低(1.06%,P<0.01),28～d组最高(21.48%,P<0.01);HCMV IgG阳性检出率以<28d和7～14岁两组高(分别为98.77%和86.54%,P均<0.01);HCMV IgM阳性浓度在6个组间分布差异无统计学意义(P=0.52),但随着年龄的增长有降低趋势(P=0.02);HCMV IgG阳性浓度以28～d组最低(P<0.05),且随着年龄的增长有升高趋势(P<0.01)。750例HCMV IgM阳性的患儿中,以呼吸道感染最多占34.80%(261/750),其中肺炎占16.93%(127/750)。结论温州地区住院患儿HCMV感染率高,以呼吸道感染为主,不同年龄组间患儿HCMV感染率及抗体浓度不同。

Objective To analyze the status of human cytomegalovirus（HCMV）infection and its serum markers in hospitalized children in Wenzhou.Methods A total of 5 215 hospitalized children were selected from March 2010 to February 2011,and were divided into six age groups,ranging from infants of less than 28 days old to children of 14 years old.Blood samples were collected for the quantification of serum IgM and IgG antibodies against HCMV using chemiluminescence immunoassay（CLIA）.Results The overall positive rates of IgM and IgG were 14.38%（750/5 215）and 82.45%（4 300/5 215）,with the lowest and highest for IgM of 1.06% and 21.45% in 28 days old infants group and in 28 days to 6 months old group（P 0.01）respectively,and for IgG antibody,the highest was found to be both in 28 days old infants group（98.77%）and in 7 to 14 years old group（86.54%）（P 0.01）.Meanwhile,12.48% of children（677/5 215）were simutanously positive for both IgM and IgG.Although there was no significant difference for IgM level among six age groups（P=0.52）,it tended to be decreasing with the age（P=0.02）.However,for IgG antibody,the lowest concentration was in children of 28 days to 6 months old（P0.05）,and there was an up trend along with age（P0.01）.Of the 750 children whose HCMV-IgM was positive,261（34.80%）suffered from respiratory infection,in which pneumonia accounted for 16.90%（127/750）.Conclusions HCMV infection is very common in hospitalized children in Wenzhou,especially respiratory infection.The prevalence and antibody concentration of HCMV vary in different age groups.