秦巴山区婴幼儿巨细胞病毒感染的相关因素探讨

The related factors of CMV infection of infants in Qinba mountain area

目的 探讨贫困山区婴幼儿不同阶段巨细胞病毒 (CMV)感染及损伤因素。方法 用PCR (聚合酶链反应 )法检测婴幼儿不同月龄晨尿CMV -DNA ;母亲问卷了解本次妊娠经过 ,新生儿期及婴幼儿期发育情况 ;对其中45例母亲孕期CMVIgM (+)者 ,同时检测分娩后 2周内乳汁CMV -DNA。结果 先天感染组婴幼儿均为母亲孕期CMV感染者 ;母亲孕期CMV原发性感染者与复发性感染者子代CMV先天感染率间差别有显著性意义 (P <0 0 1)。围生期感染组与围生期无感染组的母亲乳汁CMV -DNA阳性率间差别有显著性意义 ;围生期感染组婴幼儿以母乳喂养为主 ,出生体重偏低。获得性感染组家庭人均年收入为 734 0 0元 ,低于无感染组的 12 81 4 8元 (P <0 0 5 )。先天感染与围生期感染组婴幼儿症状性损伤与早期喂哺CMV -DNA (+)母乳有关 ,但与喂哺CMV -DNA (+)母乳持续时间无关。结论 宫内传播是CMV先天感染的主要传播途径 ,以原发性感染者明显 ,围生期感染与早期喂哺CMV-DNA (+)母乳相关 。

Objective To explore the CMV infection and injure of poor areas (Qinba area) infants in varied age and the related factories.Methods Infants were divided into different groups by the test of CMV-DNA in urine used PCR.Questionnaire was used to get the information about pregnancy process,the development of newborns and infants.There were 42 cases who were positive in CMV IgM during pregnancy,at the same time,CMV-DNA in breast milk was test too.Results Intrauterine infection rate in mother′s primary infection was higher than that of recurrent infection.There was no other congenital infection that was caused by other reasons except intrauterine infection.Perinatal infection and injuries have close relationship with breastfeeding containing CMV-DNA (P<0.05) especially more significant in infants with low new-born weight.The exhausted rate of CMV-DNA in breast milk was higher than that of no perinatal group.Acquired infection more likely occurred in infants with poor economic.Conclusion Congenital infection was caused mainly by intrauterine infection.Perinatal infection has close relationship with breast milk containing CMV-DNA (P<0.05).The infants of congenital infection,perinatal infection were injured significantly (P<0.05) when they were fed with CMV-DNA positive breast milk.Acquired infection more likely has connection with poor economic.