巨细胞病毒性疾病患儿尿HCMV-DNA水平、并发症及更昔洛韦治疗后转归分析

Analysis of urine HCMV⁃DNA level,complications and outcome after ganciclovir treatment in children with human cytomegalovirus diseases

目的观察人巨细胞病毒(HCMV)性疾病患儿尿HCMV-DNA水平、并发症,并分析更昔洛韦治疗后转归情况。方法将2017年1月至2019年9月本院收治的70例HCMV感染性疾病患儿(观察组)作为研究对象,另选择35例健康幼儿作为对照,均进行尿HCMV-DNA水平检测,记录HCMV感染性疾病患儿并发症发生情况。观察组均给予更昔洛韦治疗,对比治疗前后患儿尿HCMV-DNA水平、HCMV-DNA阳性率及肝功能指标[总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)]。结果观察组尿HCMV-DNA水平及HCMV-DNA阳性率均显著高于对照组,差异具有统计学意义(P<0.05);HCMV感染性疾病患儿并发症可见贫血(34.29%)、肺炎(24.29%)、畸形(8.57%)、视网膜炎(7.14%)、脑炎(7.14%)。治疗后,HCMV感染性疾病患儿尿HCMV-DNA水平及HCMV-DNA阳性率均较治疗前显著降低,差异具有统计学意义(P<0.05);治疗后,HCMV感染性疾病患儿TBIL、DBIL、ALT和AST水平均较治疗前显著降低,差异具有统计学意义(P<0.05)。结论 HCMV感染性疾病患儿尿HCMV-DNA水平较高,且容易发生贫血、肺炎等并发症,经更昔洛韦治疗后,患儿尿HCMV-DNA水平显著降低,肝功能也明显改善。

Objective To observe the urine HCMV⁃DNA level and complications in children with human cytomegalovirus(HCMV)diseases and analyze the outcomes after ganciclovir treatment.Methods Seventy children with HCMV diseases(observation group)who were admitted to the hospital from January 2017 to September 2019 were enrolled as the research objects.Another 35 healthy children were enrolled as con⁃trol group.All were tested for urine HCMV⁃DNA level.The occurrence of complications in children with HC⁃MV diseases was recorded.The observation group was treated with ganciclovir.The level of urine HCMV⁃DNA,positive rate of HCMV⁃DNA and liver function indexes[total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),alkaline phosphatase(ALP)]before and after treatment were com⁃pared.Results The level of urine HCMV⁃DNA and the positive rate of HCMV⁃DNA in observation group were significantly higher than those in control group,with statistically significant differences(P<0.05).The complications in children with HCMV diseases included anemia(34.29%),pneumonia(24.29%),malforma⁃tions(8.57%),retinitis(7.14%)and encephalitis(7.14%).After treatment,level of urine HCMV⁃DNA and positive rate of HCMV⁃DNA were significantly decreased,with statistically significant differences(P<0.05),levels of TBIL,DBIL,ALT and AST were significantly decreased,with statistically significant differences(P<0.05).Conclusion The level of urine HCMV⁃DNA is relatively higher in children with HCMV diseases,who are prone to complications such as anemia and pneumonia.After ganciclovir treatment,level of urine HC⁃MV⁃DNA is significantly decreased,and liver function is also significantly improved.