不同喂养方式对先天性巨细胞病毒感染新生儿病毒载量的影响

Effect of different feeding methods on viral load of neonates infected with congenital cytomegalovirus

目的探讨母乳喂养与人工喂养对先天性巨细胞病毒(CMV)感染新生儿病毒载量的影响。方法选择2016年7月至2019年6月空军军医大学第二附属医院儿科诊治的82例CMV感染无症状新生儿为研究对象,根据喂养方式的不同将其分为两组,其中31例采用母乳喂养者为观察组,51例采用人工喂养者对照组。比较两组新生儿唾液/尿液CMV DNA载量的差异,并随访至出生后6个月,观察两组新生儿的肝功能异常和脑发育异常情况。结果观察组和对照组新生儿的CMV DNA病毒载量出生3 d内[(2.62±0.51)vs(2.51±0.62)]、1个月[(1.85±0.95)vs(1.92±0.73)]、3个月[(1.82±0.92)vs(1.71±0.75)]、6个月[(1.69±0.62)vs(1.62±0.53)]比较差异均无统计学意义(P>0.05);所有新生儿均获得随访,观察组与对照组新生儿的肝功能异常(3.23%vs 0)、脑发育异常(0 vs 0)、中性细胞减少(3.23%vs 0)、贫血(3.23%vs 0)、听力异常(6.45%vs 1.96%)检出率比较差异均无统计学意义(P>0.05)。结论乳汁CMV阳性母乳喂养并不增加无症状CMV感染新生儿CMV病毒载量,亦不增加继发CMV感染风险。

Objective To investigate the effect of breast-feeding and artificial feeding on viral load of neonates infected with congenital cytomegalovirus(CMV).Methods A total of 82 asymptomatic neonates with CMV infection diagnosed and treated in the Second Affiliated Hospital of PLA Military Medical University from July 2016 to June 2019 were selected as the study objects.According to the different feeding methods,they were divided into two groups:the observation group(31 cases)were breast fed,and the control group(51 cases)were artificial fed.The difference of CMV DNA load in saliva/urine between the two groups were observed and followed up to 6 months after birth.The abnormal liver function and abnormal brain development between the two groups of neonates were observed.Results There was no significant difference in CMV DNA viral load between the observation group and the control group within 3 days,1 month,3 months and 6 months after birth:(2.62±0.51)vs(2.51±0.62),(1.85±0.95)vs(1.92±0.73),(1.82±0.92)vs(1.71±0.75),(1.69±0.62)vs(1.62±0.53),P>0.05.All newborns were followed up.There was no significant difference in the detection rate between the observation group and the control group for abnormal liver function(3.23%vs 0),brain development abnormality(0 vs 0),neutropenia(3.23%vs 0),anemia(3.23%vs 0),hearing abnormality(6.45%vs 1.96%),P>0.05.Conclusion CMV positive breast feeding does not increase the viral load of CMV in asymptomatic CMV infected newborns,and does not increase the risk of CMV infection.