听力损害新生儿巨细胞感染的调查

Prevalence of cytomegalovirus infection in neonates with hearing impairment

目的探讨听力损害新生儿巨细胞感染状况,并进一步分析其尿液病毒负荷量与听力损害的相关性,对临床研究提供可参考依据。方法选择2011年1月-2015年1月100例存在听力损害的新生儿作为研究对象,所有新生儿均行脑干听觉诱发电位(BAEP)检查,且空腹采集静脉血行抗人巨细胞病毒IgM抗体测定;同时对巨细胞感染的新生儿采用荧光定量PCR检测尿液巨细胞病毒DNA含量,分析尿液病毒负荷量与听力损害的相关性。结果 100例听力损害新生儿中有20例存在巨细胞感染占20.0%,巨细胞感染新生儿BAEP异常60.0%,明显高于非巨细胞感染新生儿的28.8%,差异有统计学意义(P<0.05);巨细胞感染BAEP异常新生儿病毒负荷量明显高于巨细胞感染BAEP正常新生儿,差异有统计学意义(P<0.05);取病毒负荷量5.1为临界点,其中高病毒负荷新生儿11例,低病毒负荷新生儿9例;高病毒负荷新生儿重度听阈损害54.5%,明显高于低病毒负荷新生儿的22.2%,差异有统计学意义(P<0.05)。结论巨细胞感染新生儿容易发生听力损害,且尿液病毒负荷量与听力损害程度正相关,但不能提示损害类型。

OBJECTIVE To explore the prevalence of cytomegalovirus infection in neonates with hearing impairment and further analyze the relationship between viral load in urine and hearing impairment so as to provide guidance for clinical study.METHODS A total of 100 neonates with hearing impairment who were treated in the hospital from Jan 2011 to Jan 2015 were recruited as the study objects,then the brainstem auditory evoked potential（BAEP）examination was conducted for all the enrolled neonates,the fasting venous blood specimens were collected to detect IgM antibody of cytomegalovirus,the cytomegalovirus DNA contents in urine were determined for the neonates with cytomegalovirus infection by using fluorescence quantitative PCR,and the relationship between the viral load in urine and the hearing impairment was observed.RESULTS Of the 100 neonates with hearing impairment,20（20.0%）had the cytomegalovirus infection;60.0% of the neonates with cytomegalovirus infection showed abnormal BAEP,significantly higher than 28.8% of the neonates with non-cytomegalovirus infection（P〈0.05）.The viral load of the cytomegalovirus infection neonates with abnormal BAEP was significantly higher than that of the cytomegalovirus infection neonates with normal BAEP（P〈0.05）.As the viral load 5.1was set as the critical point,11 neonates had high viral load,and 9neonates had low viral load;54.5% of the neonates with high viral load had severe damage to hearing threshold,significantly higher than 22.2% of the neonates with low viral load（P〈0.05）.CONCLUSION The neonates with cytomegalovirus infections tend to have the hearing impairment;the viral load in urine is positively correlated with the degree of hearing impairment but can not indicate the type of impairment.