比较先天性和围生期巨细胞病毒性肝炎的临床特征及疗效.pdfVIP

医学临床研究 2007年12月 第24卷 第 12期 J Clin Res，Dec．2007，Vol 24，No12 · 论著· 比较先天性和围生期巨细胞病毒性肝炎的临床特征及疗效 张劲松 罗如平 于四景 欧敏 (湖南省儿童医院感染科，湖南 长沙 410007) [摘要]【目的】探讨先天性和围生期巨细胞病毒性肝炎的临床特点、并存症及疗效。【方法】将本科2004 ～ 2005年收住的CMV肝炎9O例，按生后2周内发病分为先天性感染组和生后2～12周为围生期感染组，分 别比较两组肝脾大小、大便颜色、总胆红素(TB)、结合胆红素(DB)、谷丙转氨酶(ALT)、y-GT的高低、并存症 (脑损伤、胆道闭锁等各种畸形)的发生率及疗效。【结果】发现A组淤胆重、肝肿大、TB及DB较B组高，而 脾肿大、谷丙转氨酶无明显差异，脑损伤及先天性畸形发生率高，疗效较B组差。【结论】先天性巨细胞病毒 性肝炎临床症状重、容易遗留神经系统的各种后遗症，且多并存先天畸形，目前无特效药物治疗。 [关键词] 肝炎，病毒性，人／治疗； 巨细胞病毒感染 Study of Clinical Features and Curative effect of Congenital and Perinatal Human Cytomegalov。 irus Hepatitis ZHANG Jing-song， LUO Ru-ping， yU Si—jing， al(Department of Infection， Children S Hospital of Hunan Province，Changsha 410007，China) [-Abstract][Objective]To approach the clinical features and curative effect of congenital and perinatal hu— man cytomegalovirus(CMV)hepatitis．[Methods]There were 90 CMV hepatitis from our department between 2004 to 2005．These children were divided into two group，congenital infection(Group A)and perinatal infec— tion(Group B)．Then the size of liver and spleen，the color of sedes，the levels of TB，DB，ALT，Y-GT and complications(brain injury，biliary atresia，etc)were compared．【Results]In Group A，the levels of hep— atauxe，TB，DB and complications(congenital deformities such as brain injury，biliary atresia，etc)were more than those in Group B． There was no difference in enlarged spleen and ALT between two groups． [Conclusion]Congenital cytomegalovirus hepatitis is severe in clinical symptoms，and it can remain neurologi— cal sequelae and concomitant congenital deformities．There is no specific remedy for this disease． [Key words] hepatitis，viral，human／TH； cytomegalovirus infections [中图分类号] R725．126 [文献标识码] A [文章编号] 1671—7171(2007)12—2092—03 巨细胞病毒(cytomegalovirus，CMV)在人群中 后2周内发病为先天性感染(A组)，共58例；生后2 感染非常普遍，但大多数呈I临床不显性感染或潜伏