母体携带HCMV-DNA对母乳喂养HCMV感染患儿生长发育与细胞免疫和体液免疫的影响

Effects of maternal HCMV-DNA on growth,cellular immunity and humoral immunity of breastfeeding children with HCMV infection

目的探讨母体携带人巨细胞病毒(HCMV)-DNA对母乳喂养HCMV感染患儿生长发育、细胞免疫和体液免疫的影响。方法选择2022年1月-2023年1月山东省泰安市妇幼保健院新生儿科收治的145例母乳喂养HCMV感染患儿为研究对象,根据患儿母亲的母乳中HCMV-DNA是否为阳性分为阳性组(n=82)和阴性组(n=63)。采用实时荧光定量聚合酶链式反应(PCR)检测患儿尿液及母乳中HCMV-DNA含量。入院时,由儿科医师测量并记录患儿头围、身高和体质量。采用Gesell发育量表评估患儿发育商(DQ);采用耳声发射听力(DPOA)检查患儿听力;采用新生儿20项行为神经测定量表(NBNA)评价神经发育。采用流式细胞仪检测T淋巴细胞亚群,采用免疫比浊法检测免疫球蛋白。结果阳性组和阴性组母乳喂养HCMV感染患儿头围、身高、体质量、DQ值、NBNA值、DPOA、CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、免疫球蛋白(Ig)G、IgA、IgM比较,均差异无统计学意义。结论母体携带HCMV-DNA对母乳喂养HCMV感染患儿生长发育和免疫功能的影响不显著。

OBJECTIVE To explore the effects of maternal human cytomegalovirus(HCMV)-DNA on growth and development,cellular immunity and humoral immunity of breastfeeding children with HCMV infection.METHODS A total of 145 breastfeeding children with HCMV infection admitted to neonatology department of Ta-ian Maternal and Child Health Hospital between Jan 2022 and Jan 2023 were enrolled as the research sub-jects.According to maternal HCMV-DNA,they were divided into the positive group(n=82)and negative group(n=63).HCMV-DNA in children's urine and breast milk was detected by real-time fluorescent quantitative poly-merase chain reaction(PCR).On admission,head circumference,height and body mass were measured and recor-ded by the paediatrician.The development quotient(DQ)was evaluated by Gesell development scale.The hearing of children was examined by stortion product otoacoustic emission(DPOA).The neurodevelopment was evaluated by neonatal behavioral neurological assessment(NBNA).The lymphocyte subsets were detected by flow cytome-try,and immunoglobulins were detected by immunoturbidimetry.RESULTS There were no significant difference in head circumference,height,body mass,DQ,NBNA,DPOA,CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),immuno-globulin(Ig)G,IgA or IgM between the positive group and negative group.CONCLUSION Maternal HCMV-DNA has no significant effect on growth and development and immune function in breastfeeding children with HC-MV infection.