巨细胞病毒感染对婴幼儿听力及言语发育的影响

Effects of cytomegalovirus infection on infants'hearing and speech development

目的:探讨巨细胞病毒(CMV)感染对婴幼儿听力及言语发育的影响。方法:选取192例CMV感染婴幼儿为研究对象(CMV组),选取同期于郑州大学第二附属医院门诊体检的320例正常婴幼儿作为对照组。采用瞬态诱发性耳声发射行听力初筛,与自动听性脑干反应联合筛查对CMV感染婴幼儿进行听力随访,未通过者行听性脑干反应、声导抗等检查。两组婴幼儿分别于12、24、36月龄时采用Gesell发育量表进行言语发育评估。结果:CMV组听力筛查(初筛和42 d复筛)未通过率分别为28_65%(55/192)、31.77%(61/192),对照组未通过率分别为9.06%(29/320)、4.06%(13/320),两组初筛和复筛结果差异有统计学意义(P<0.05)。CMV组未通过者3月龄时听力诊断发现听力异常48例,其中分泌性中耳炎11例,先天性感音神经性聋37例。随访至36月龄,CMV组共确诊SNHL 58例(30.21%),其中先天性SNHL 37例(19.27%),迟发性SNHL 21例(10.94%)。CMV组发育商(DQ)12、24、36月龄分别为92.05±4.68、86.53±4.46、85.92±4.82,对照组DQ值分别为93.10±4.56、94.35±4.52、95.03±4.16,24、36月龄DQ值差异有统计学意义(P<0.05)。结论:CMV感染是婴幼儿听力损失的高危因素,且听力损失具有波动性、迟发性和渐进性等特点,应加强其听力及言语发育随访。

Objective:To investigate the effects of cytomegalovirus(CMV)infection on infants*hearing and speech development.Methods:A total of 192 infants with cytomegalovirus infection were selected as research objects(CMV group).Among 320 normal infants who received physical examinations in the Second Affiliated Hospital of Zhengzhou University during the same period were selected as the control group.Using transiently evoked otoacoustic emission to conduct initial hearing screening.Jointing automatic auditory brainstem response screening method to follow up for infants infected with cytomegalovirus.Those who failed to pass the screening were diagnosed with auditory brainstem response and acoustic immittance examination.The two groups of infants were evaluated for follow-up at the age of 12,24,36 months using the Gesell Development scale.Results:Hearing screening(initial hearing screening and 42 d hearing re-screening):CMV group retrospectively failed rates 28.65%(55/192),31.77%(61/192),normal control group retrospectively failed rates 9.06%(29/320),4.06%(13/320),the results of the two groups'hearing screening showed statistically significant differences(P<0.05).48 cases of diagnostic ABR were abnormal in CMV group in 3 month's hearing diagnosis,including 11 cases ofsecre-tory otitis media,37 cases of sensorineural hearing loss.Follow-up for 36 months,192 infants with CMV infection were confirmed congenital SNHL 37 cases(19.27%),21 cases of delayed SNHL(10.94%),a total of diagno-sis with SNHL 58 cases(30.21%).The development quotient(DQ)of CMV group were respectively 92.05±4.68,86.53±4.46,85.92±4.82 in 12,24,36 months,and the DQ value of the normal control group were re-spectively 93.10±4.56,94.35±4.52,95.03±4.16.At the age of 24,36 months,the DQ value of two groups'differences were statistically significant(P<0.05).Conclusion:CMV infection is hearing loss'risk factors.It had the characteristics of volatility,delay and progressive decline.Follow-up should be strengthened for hearing and speech development.