先天性人巨细胞病毒感染对新生儿凝血功能和铁代谢及生长发育的影响

Influence of congenital human cytomegalovirus infection on coagulation function,iron metabolism,growth and development of neonates

目的 探究先天性人巨细胞病毒(HCMV)感染对新生儿凝血功能、铁代谢及生长发育的影响。方法 将绍兴市中心医院2021年7月—2022年12月出生的127例先天性HCMV感染新生儿纳入研究组,另随机抽取医院同期出生的健康新生儿125名纳入对照组。比较两组凝血功能[纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)、活化凝血活酶时间(APTT)、凝血酶原时间(PT)]、铁代谢[血清铁(SI)、血清铁蛋白(SF)、血清转铁蛋白(TRF)和血红蛋白(Hb)]及生长发育情况。结果 研究组新生儿临床特征以宫内生长受限、病理性黄疸、血小板减少症较为常见,发生率分别为28.35%(36/127)、23.62%(30/127)、21.26%(27/127);研究组新生儿FIB、D-D水平均高于对照组,PLT、APTT、PT、SI、SF、TRF及Hb水平均低于对照组(P<0.05);两组新生儿出生时及出生后6个月的体质量、头围、身长、上臀围比较,均无统计学差异;出生后6个月,研究组新生儿单耳及双耳听力损伤发生率均高于对照组(P<0.05),研究组新生儿适应性、大运动能力、精细动作、言语表达的神经发育商(DQ)值均低于对照组(P<0.05)。结论 先天性HCMV感染会影响新生儿凝血功能及铁代谢,增加新生儿听力及神经损伤风险。

OBJECTIVE To observe the influence of congenital human cytomegalovirus(HCMV)infection in coagu-lation function,iron metabolism,growth and development of neonates.METHODS A total of 127 neonates with congenital HCMV infection who were treated in Shaoxing Central Hospital from Jul 2021 to Dec 2022 were as-signed as the study group,meanwhile,125 healthy neonates were chosen as the control group.The coagulation in-dexes[fibrinogen(FIB).D-dimer(D-D),platelet count(PLT),activated partial thromboplastin time(APTT),prothrombin time(PT)],iron metabolism indexes[serum iron(SI),serum ferritin(SF),serum transferrin(TRF),hemoglobin(Hb)]and growth and development were observed and compared between the two groups.RESULTS The restriction of intrauterine growth,pathological jaundice and thrombocytopenia were the common clinical characteristics among the neonates in the study group,the incidence rates were 28.35%(36/127),23.62%(30/127)and 21.26%(27/127),respectively.The levels of FIB and D-D of the study group were higher than those of the control group,while the levels of PLT,APTT,PT、SI,SF,TRF and Hb of the study group were lower than those of the control group(P<0.05).There were no significant differences in the body weight,head circumference,height and high hip between the two groups of neonates at the birth and after the birth for 6 months.The incidence of monaural and binaural hearing impairment of the study group was higher than that of the control group after the birth for 6 months(P<0.05).The DQ values of neonatal adaptability,gross motor ability,fine motor and speech expression of the study group were lower than those of the control group(P<0.05).CONCLUSION The congenital HCMV infection may affect the coagulation function and iron metabolism of the ne-onates and increase the risk of hearing and nerve injury.