母乳喂养对婴儿唾液巨细胞病毒载量的影响

Effect of breastfeeding on infant cytomegalovirus viral load

目的 对先天性巨细胞病毒（CMV）感染的新生儿进行随访监测,探讨母乳喂养对CMV载量变化的影响.方法 采集2010年11月至2012年2月在常州市妇幼保健院山生的新生儿唾液进行CMV感染筛查,排除早产、严重感染性疾病或畸形等,对阳性感染且.无症状的足月新生儿根据母亲自主选择分成人工喂养组及母乳喂养组,随访至6个月,分别在出生1个月内、3个月、6个月采集唾液及母乳,采取实时荧光定量PCR法检测CMV-DNA的载量变化,同时行体格检查、头颅B超检查、耳声发射听力筛查、肝功能、血常规分析等检查.结果 30例婴儿在随访的6个月中均末发现有CMV感染性疾病的表现.人工喂养组与母乳喂养组婴儿在出生1个月内、3个月、6个月唾液巨细胞DNA载量末见明显变化（t=2.832、3.161、3.475,P均＞0.05）.母乳喂养组乳汁在山生1个月内、3个月、6个月CMV-DNA载量分别为3.125×103±2.017×102、2.688×103±2.251×102、3.016×103 ±2.613×102,三者比较差异无统计学意义（F=1.725,P=0.667）.头颅B超检查、耳声发射听力筛查、肝功能、血常规分析等检查末见明显异常.结论 CMV感染的足月无症状新生儿,即便母乳中CMV 阳性,继续母乳喂养后婴儿体内的病毒载量也不会增加,也末发现继发性的症状感染.

Objective Follow-up monitoring was carried out in infants infected with cytomegalovirus （CMV） so as to find out whether breastfeeding could bring about changes of CMV viral load.Methods Saliva of the neonates born in Changzhou Maternal and Child Health Hospital from Nov.2010 to Feb.2012,was collected for CMV screening.Premature infants,or the infants with seriously infectious diseases and deformities were excluded,such as severe intrauterine infection,congenital immune deficiency disease and so on.The full-term infants with aymptomatic infection were divided into the artificial feeding group and the breastfeeding group,and followed up for 6 months.During the 1st,the 3rd and the 6th month after their birth,their saliva and their mother＇s breast milk were collected.The method of realtime fluorescent quantitative PCR was adopted to test the changes in the viral load of CMV-DNA in the saliva and breast milk.Meanwhile,head B-ultrasound test,otoacoustic emission hearing screening,liver function test,blood routine analysis and so on were performed.Results Among infants from both artificial feeding group and breastfeeding group,during the 1 st,the 3 rd and the 6th month after birth,no significant changes in the DNA viral load of saliva and breast milk cytomegalovirus were found （t =2.832,3.161,3.475,all P 〉 0.05）.And in breastfeeding group,the cytomegalovirus DNA viral load in breast milk were 3.125 × 103 ±2.017 × 102 （the 1st month）,2.688 × 103 ±2.251 × 102 （the 3rd month）,3.016 × 103 ±2.613 × 102 （the 6th rmonth）,also no significance during the time （F =1.725,P =0.667）.Meanwhile,the head B-ultrasound,otoacoustic emission hearing screening,liver function test,blood routine analysis,etc showed no clinical significance （F =1.725,P =0.667）.Conclusions In the CMV-infected neonates,even if CMV in breast milk is tested to be positive,breastfeeding can continue without causing secondary symptoms of infection.