巨细胞病毒感染致儿童听力损伤危险因素分析

Analysis on risk factors of hearing loss caused by Cytomegalovirus infection in Children

目的:探讨巨细胞病毒感染致儿童听力损伤的危险因素。方法:回顾性分析2018年1月至2020年12年在本院确诊的153例巨细胞病毒感染患儿的临床资料,根据听性脑干反应(Auditory brainstem response,ABR)检查结果,分为听力损伤组57例和听力正常组96例,比较两组临床资料,并采用单因素比较和多因素回归分析巨细胞病毒患儿发生听力损伤的危险因素。结果:153例巨细胞病毒感染患儿中,57例发生听力损伤,单因素分析结果显示巨细胞病毒感染所致听力损伤的危险因素包括早产儿、低出生体质量儿、血小板减少、血HCMV-IgM阳性、血HCMV-DNA高病毒载量、尿HCMV-DNA高病毒载量、胆汁淤积、脑发育迟缓、颅脑MRI异常、合并畸形,差异显著(P<0.05)。Logistic多因素分析结果显示,早产儿、低出生体质量儿、血小板减少、血HCMV-IgM阳性以及血HCMV-DNA高病毒载量、尿HCMV-DNA高病毒载量是巨细胞病毒感染致儿童听力损伤的独立危险因素(P<0.05)。结论:儿童巨细胞病毒感染所致听力损伤的独立危险因素为早产儿、低出生体质量儿、合并血小板减少、血HCMV-IgM阳性以及血HCMV-DNA高病毒载量、尿HCMV-DNA高病毒载量。

Objective:To explore the risk factors of hearing loss caused by Cytomegalovirus infection in children.Methods:Retrospectively analyzed the clinical data of 153 children with HCMV infection diagnosed in Maternity and Child Health Care of Zaozhuang from January 2018 to 2020,according to the results of auditory brainstem response(ABR),they were divided into 57 cases in the hearing loss group and 96 cases in the hearing normal group.The clinical data of the two groups were compared,and univariate comparison and multivariate regression were used to analyze the risk factors for hearing loss in children with HCMV.Results:Among the 153 children with HCMV,57 cases had hearing impairment,and univariate analysis showed that the risk factors for hearing loss caused by CMV infection included preterm birth,low birth weight,thrombocytopenia,blood HCMV-IgM positivity,high blood HCMV-DNA virus load,cholestasis,brain retardation,cranial MRI abnormalities,and associated malformations,the differences were statistically significant(all P<0.05).Logistic multivariate analysis showed that preterm birth,low birth weight,thrombocytopenia,positive blood HCMV-IgM,and high load of blood/urine HCMV-DNA virus were independent risk factors for hearing loss in children with cytomegalovirus infection(P<0.05).Conclusion:The independent risk factors for hearing loss due to cytomegalovirus infection in children are preterm birth,low birth weight,thrombocytopenia,positive blood HCMV-IgM,and high blood/urine HCMV-DNA viral load.