先天性症状性巨细胞病毒感染脑脊液病毒载量与听力损伤相关性

Association between cerebrospinal fluid viral load and hearing loss in neonates with congenital symptomatic cytomegalovirus infection

目的 探讨症状性先天性巨细胞病毒（cytomegalovirus,CMV）感染新生儿脑脊液（cerebrospinal fluid,CSF） CMV DNA载量与感音性听力损伤（sensorineural hearing loss,SNHL）的相关性.方法 36例先天性症状性CMV感染患儿,PCR法检测CSF CMV DNA载量,并于出生1个月内、生后6个月及1年左右行脑干听觉诱发电位检测.结果 （1）36例患儿,其中CSF CMV DNA阳性15例,阳性率41.2％,SNHL17例,SNHL发生率47.2％.（2） CSF CMV DNA阳性组SNHL发生率60.0％（9/15）;阴性组SNHL发生率38.1％ （8/21）,两组发生率比较差异无统计学意义（P =0.194）.（3）CSFCMVDNA阳性组中,SNHL组与听力正常组CSF CMV DNA载量为3.35 ±0.68和3.17±0.56,两组载量比较,差异无统计学意义（P=0.36）.结论 先天性症状性CMV感染患儿CSF CMV DNA是否阳性及其载量不是预测SNHL的指标.

Objective To determine the relationship between the viral load of cerebrospinal fluid （CSF） and sensorineural hearing loss （SNHL） in newborns with symptomatic congenital cytomegalovirus （CMV） infection.Methods The study cohort comprised 36 newborns with symptomatic congenital CMV infection.CSF from all of the patients were analyzed for the presence of CMV DNA by PCR.Audiological function were performed on them by brain stem auditory evoked potential at birth,at 6 and 12 months of age.Results （1）Of the 36 newborns,15 cases （41.7％） had positive CSF PCR result,17 cases （47.2％） had SNHL.（2） The prevalence of SNHL in the group of newborns with positive CSF PCR result was 60.0％ （9/15）,and it was 38.1％ （8/21） in the group of newborns with negative CSF PCR result,there was no significant difference of the prevalence of SNHL between the two groups （P =0.194）.（3） In newborns with positive CSF PCR result,the amounts of CSF CMV DNA was not different between the newborns with SNHL and normal hearing （3.35 ± 0.68 vs.3.17 ± 0.56,P =0.36）.Conclusion A positive CSF PCR result and the CMV viral load of CSF did not correlate with SNHL.