婴儿巨细胞病毒肝炎临床探究.docVIP

婴儿巨细胞病毒肝炎临床探究 　 作者：吴伟森，黄建美，连楚南 【关键词】 婴儿；肝炎；巨细胞病毒 　　摘要：目的：总结婴儿巨细胞病毒(CMV)肝炎的临床特点，使用更昔洛韦治疗并观察其疗效。方法：对2001年1月至2005年12月确诊CMV肝炎的30例婴儿进行回顾性研究。结果：婴儿CMV肝炎的临床表现轻重不一，临床主要表现为黄疸、肝脾肿大及肝功能异常，并可同时累及其它系统；应用更昔洛韦治疗，87%(26/30)病例黄疸及80%(24/30)的血清谷丙转氨酶(ALT)下降，且无明显不良反应，随访肝功能，肝脾肿大逐渐恢复。结论：CMV肝炎临床主要表现为黄疸、肝脾肿大及肝功能异常，应用更昔洛韦治疗具有良好的疗效。 　　关键词：婴儿；肝炎；巨细胞病毒 　　The Clinical Study of Infantile Cytomegalovirus Hepatitis 　　Abstract： Objective: To summarize the clinical features of 30 cases that had suffered infantile cytomegalovirus hepatitis and to observe the therapeutic effects of ganciclovir. Method: The clinical manifestations of 30 cases of infantile cytomegalovirus hepatitis during January 2001 to December 2005 were collected and the therapeutic effects and side-effects of ganciclovir were observed. Result: The clinical manifestations of infantile cytomegalovirus hepatitis were different in degrees. Jaundice, hepatosplenomegaly and abnormal hepatic function were common. In these cases and there were also other systems that might be affected. After treated by ganciclovir, jaundice was disappeared in 87%(26/30) cases and serum ALT was decreased in 80%(24/30) cases. No side-effects happened. During follow-up period, the hepatosplenomegaly was lightened and the hepatic functions were turned to be normal. Conclusion: The clinical manifestations of infantile cytomegalovirus hepatitis were mainly jaundice and hepatosplenomegaly with abnormal hepatic function and ganciclovir had better therapeutic effects to the disease. 　　Key words：Infant；Hepatitis；Cytomegalovirus 　　巨细胞病毒(CMV)感染在我国极广泛，据文献报道，全国育龄妇女血清CMV-IgG阳性率高达96%，是婴儿肝炎综合征常见病因之一，主要累及肝脏。通过对2001年1月至2005年12月在我院住院确诊为CMV肝炎的30例婴儿进行分析,总结其临床特点，并应用更昔洛韦进行治疗，取得良好疗效，现报道如下： 　　1临床资料 　　1.1一般资料：2001年1月至2005年12月我院收治巨细胞病毒肝炎30例，其中男18例，女12例，年龄2周内3例，～3月23例，大于3月4例。本组患儿均确诊，查血清抗-CMV-IGM（+），抗-CMV-IgG（+）。临床诊断依据中华医学会儿科学分会制定的CMV感染诊疗方案［1］。 　　1.2临床表现：黄疸为CMV肝炎最常见的首发症状，表现为出生后黄疸持续不退17例，出生后2周至1个月出现黄疸12例，3月龄出现黄疸1例；本组患儿均有肝肿大，其中25例为轻中度肿大，5例为重度肿大,质地较硬；脾脏肿大26例,，2例并发肝硬化伴腹水；消化道症状(16/30)，表现为纳差、呕