巨细胞病毒感染肺炎婴幼儿听力检测结果分析

The Clinical Audiological Characteristics of Infants with Human Cytomegalovirus Pneumonia

目的探讨人巨细胞病毒(human cytomegalovirus,HCMV,简称CMV)感染肺炎婴幼儿的听力学特点。方法以确诊为CMV感染肺炎婴幼儿(CMV感染组)115例(230耳)为研究对象,并选取同期非CMV感染肺炎婴幼儿(非CMV感染组)115例(230耳)以及健康婴幼儿115例(230耳)(对照组),分别进行听性脑干反应(auditory brainsen response,ABR)、声导抗测试,比较三组的结果及听力随访情况。结果CMV感染组50耳(21.74%)、非CMV感染组34耳(14.78%)、健康对照组17耳(7.39%)ABR波V阈值>30dB nHL(P<0.05);CMV感染组感音神经性听力损失检出率(16.96%,39/230)高于非CMV感染组(6.52%,15/230)和健康对照组(1.74%,4/230)(P<0.05);CMV感染组(8.70%,20/230)、非CMV感染组(12.17%,28/230)声导抗异常耳均高于健康对照组(2.61%,6/230),CMV感染组、非CMV感染组组间差异无统计学意义(P>0.05);随访3年,CMV感染组有3例感音神经性听力损失者听力恢复正常,各组其余感音神经性听力损失患儿听力无改善,各组传导性听力损失者均恢复正常。结论 CMV感染肺炎婴幼儿感音神经性聋发病率高,CMV感染肺炎容易导致中耳功能异常引起ABR反应阈升高;对于CMV感染肺炎婴幼儿需要行综合听力学检测且长期随访。

Objective To study the audiology characteristics of infants with human cytomegalovirus(HMCV)pneumonia.Methods Auditory brainstem response(ABR)and acoustic impedance test were carried on the following three groups respectively.The CMV(+)group had 115 infants who have been diagnosed with CMV pneumonia.CMV(-)group had 115 infants with pneumonia but did not have CMV infection.The control Group had115 healthy children during the same period.A comprehensive evaluation of audiological characteristics and followup of hearing changes were studied.Results(1)The CMV(+)group had 50 ears(21.74%),the CMV(-)group had 34 ears(14.78%),and the healthy group had 17 ears 7.39%in ABR V wave threshold over 30 dB nHL.(2)The CMV(+)group had the highest rate of sensorineural hearing loss(SNHL)compared with the CMV(-)and health control groups.(3)The percentages of the abnormal conductive hearing loss(CHL)in the CMV(+)group and CMV(-)group were higher than the health control group while there was no obvious difference between the CMV(+)and the CMV(-)groups.(4)During a 3-year follow-up,3 infants in the CMV(+)group who suffered SHL recovered while all the infants suffered CHL recovered in hearing.Conclusion Infants with CMV pneumonia have a higher rate of SHL,and pneumonia is likely to cause dysfunction of the middle ear,which might lead to CHL.We need to test infants with CMV pneumonia through thorough clinical audiology examinations and a longterm follow-up.