摘要
目的观察缬更昔洛韦(VGCV)治疗早产儿先天性巨细胞病毒(CMV)感染的疗效及安全性。方法选取2016年1月1日至2020年3月31日在徐州医科大学附属淮安妇幼临床学院新生儿科住院的先天性CMV感染病例28例为研究对象,其中早产儿10例(早产儿组)、足月儿18例(足月儿组)。两组均口服VGCV治疗,观察并比较两组尿CMV-DNA、血清CMV-IgM、谷丙转氨酶、头颅MRI、脉络膜视网膜炎、自动脑干听性诱发电位、中性粒细胞减少症等情况。结果早产儿组的平均胎龄及出生体重均明显低于足月儿组(t值分别为2.919、5.612,P<0.05),早产儿组治疗前自动听性脑干诱发电位(AABR)未通过率显著高于足月儿组(χ^(2)=5.593,P<0.05)。VGCV对两组患儿均有明显疗效,两组患儿尿CMV-DNA阳性、血清CMV-IgM阳性、AABR异常、脉络膜视网膜炎、头颅MRI异常、血小板减少症、肝功能异常发生率差异均无统计学意义(χ^(2)=0.008~0.996,P>0.05),两组治疗效果相似。两组中性粒细胞减少症发生率差异无统计学意义(χ^(2)=0.440,P>0.05)。结论早产儿口服VGCV治疗早产儿先天性CMV感染具有较好的疗效,与先天性CMV感染足月儿相比未增加不良反应,其对听力损伤短期内可能具有更好的保护作用,值得临床推广。
Objective To observe the efficacy and safety of oral valganciclovir(VGCV) in the treatment of premature newborns with congenital cytomegalovirus(CMV) infection.Methods 28 cases of congenital CMV infection hospitalized in the Department of Neonatology, the Affiliated Huai′an Maternity and Child Clinical College of Xuzhou Medical University from January 1,2016,to March 31,2020,were selected as the research objects, including 10 premature infants(premature infant group) and 18 term infants(term infant group).Both groups were treated with VGCV orally.Urine CMV-DNA titers, serum CMV-IgM,alanine aminotransferase, cranial MRI,chorioretinitis, automated auditory brainstem response and neutropenia of two groups were observed and compared.Results The average gestational age and birth weight of the preterm infant group were significantly lower than those of the term infant group(t=2.919 and 5.612,respectively, both P<0.05).The failure rate of automatic auditory brainstem evoked potential(AABR) before treatment in the premature infant group was significantly higher than that in the term infant group(χ^(2)=5.593,P<0.05).VGCV had an obvious curative effect on the two groups of infants.There was no significant difference in the positive rate of urine CMV-DNA,the serum CMV-IgM positive rate, abnormal AABR,chorioretinitis, abnormal head MRI,thrombocytopenia, and abnormal liver function between the two groups of infants(χ^(2)=0.008~0.996,all P>0.05),the treatment effects of the two groups were similar.There was no statistically significant difference in the incidence of neutropenia between the two groups(χ^(2)=0.440, P>0.05).Conclusion Oral VGCV in preterm infants has a good effect on the treatment of congenital CMV infection in preterm infants.Compared with congenital CMV infection in term infants, it does not increase adverse reactions.It may have a better protective effect on hearing damage in the short term and is worthy of clinical promotion.
作者
周利
杨利丽
王静
潘兆军
ZHOU Li;YANG Lili;WANG Jing;PAN Zhaojun(Department of Pediatrics,The Af filiated Huai'an Hospital of Xuzhou Medical University,Jiangsu Huaian 223002,China;Department of Neonatology,The Affiliated Huai an Maternity and Child Clinical College of Xuzhou Medical University,Jiangsu Huai'an 223002,China)
出处
《中国妇幼健康研究》
2021年第6期905-908,共4页
Chinese Journal of Woman and Child Health Research
基金
江苏省妇幼健康科研资助项目(F201609)。
