医学检验与临床
醫學檢驗與臨床
의학검험여림상
MEDICAL LATORATORY SCIENCE AND CLINICES
2014年
3期
20-22
,共3页
梁志强%刘冰%朱亚芹%张诒勋%徐新立
樑誌彊%劉冰%硃亞芹%張詒勛%徐新立
량지강%류빙%주아근%장이훈%서신립
巨细胞病毒%肺炎%婴儿%诊断
巨細胞病毒%肺炎%嬰兒%診斷
거세포병독%폐염%영인%진단
Cytomegalovirus%Pneumonia%Infants%Diagnosis
目的：探讨济宁地区6月龄以下住院肺炎患儿巨细胞病毒（CMV）感染情况及临床特点。方法：研究对象为2010年1月～2012年12月临床诊断为肺炎的住院患儿。采用酶联免疫斑点技术对6月龄以下住院肺炎患儿血清进行CMV-IgM抗体检测。结果：848例肺炎患儿中，137例CMV-IgM抗体阳性，感染率16.16%；男女感染率分别为17.11%和13.75%，差异无统计学意义（χ2=1.43，P =0.23）。0～1个月、1～3个月、3～5个月和5～6个月年龄组感染率分别为9.57%、28.16%、11.17%和10.89%；1～3个月年龄组CMV感染率明显高于其它各年龄组（χ2=43.99，P＜0.01）。春、夏、秋、冬季CMV感染率分别为14.19%、12.23%、13.30%和20.11%，差异无统计学意义（χ2=7.36，P =0.061）；但冬季CMV感染例数占总感染例数的52.55%，冬季相对较多。137例CMV感染患儿中，＜2周2例（1.46%），3～12周103例（75.18%），＞12周32例（23.36%），以围生期感染居多；母乳喂养120例，其中足月儿105例（87.50%），早产儿15例（12.50%），哺乳期足月儿CMV感染占有相当大的比例。婴儿巨细胞病毒肺炎常出现咳嗽、气促、喘息、肺部啰音以及发热等症状、体征，肺CT影像学诊断的敏感度优于X线检查。结论：CMV是引起6月龄以下婴儿肺炎的重要病原体，1～3月龄的婴儿为易感人群。婴儿 CM V 肺炎临床表现缺乏特异性，血清 CMV-IgM 抗体阳性是 CMV肺炎的实验室诊断依据，影像学诊断主要依靠肺 CT。
目的：探討濟寧地區6月齡以下住院肺炎患兒巨細胞病毒（CMV）感染情況及臨床特點。方法：研究對象為2010年1月～2012年12月臨床診斷為肺炎的住院患兒。採用酶聯免疫斑點技術對6月齡以下住院肺炎患兒血清進行CMV-IgM抗體檢測。結果：848例肺炎患兒中，137例CMV-IgM抗體暘性，感染率16.16%；男女感染率分彆為17.11%和13.75%，差異無統計學意義（χ2=1.43，P =0.23）。0～1箇月、1～3箇月、3～5箇月和5～6箇月年齡組感染率分彆為9.57%、28.16%、11.17%和10.89%；1～3箇月年齡組CMV感染率明顯高于其它各年齡組（χ2=43.99，P＜0.01）。春、夏、鞦、鼕季CMV感染率分彆為14.19%、12.23%、13.30%和20.11%，差異無統計學意義（χ2=7.36，P =0.061）；但鼕季CMV感染例數佔總感染例數的52.55%，鼕季相對較多。137例CMV感染患兒中，＜2週2例（1.46%），3～12週103例（75.18%），＞12週32例（23.36%），以圍生期感染居多；母乳餵養120例，其中足月兒105例（87.50%），早產兒15例（12.50%），哺乳期足月兒CMV感染佔有相噹大的比例。嬰兒巨細胞病毒肺炎常齣現咳嗽、氣促、喘息、肺部啰音以及髮熱等癥狀、體徵，肺CT影像學診斷的敏感度優于X線檢查。結論：CMV是引起6月齡以下嬰兒肺炎的重要病原體，1～3月齡的嬰兒為易感人群。嬰兒 CM V 肺炎臨床錶現缺乏特異性，血清 CMV-IgM 抗體暘性是 CMV肺炎的實驗室診斷依據，影像學診斷主要依靠肺 CT。
목적：탐토제저지구6월령이하주원폐염환인거세포병독（CMV）감염정황급림상특점。방법：연구대상위2010년1월～2012년12월림상진단위폐염적주원환인。채용매련면역반점기술대6월령이하주원폐염환인혈청진행CMV-IgM항체검측。결과：848례폐염환인중，137례CMV-IgM항체양성，감염솔16.16%；남녀감염솔분별위17.11%화13.75%，차이무통계학의의（χ2=1.43，P =0.23）。0～1개월、1～3개월、3～5개월화5～6개월년령조감염솔분별위9.57%、28.16%、11.17%화10.89%；1～3개월년령조CMV감염솔명현고우기타각년령조（χ2=43.99，P＜0.01）。춘、하、추、동계CMV감염솔분별위14.19%、12.23%、13.30%화20.11%，차이무통계학의의（χ2=7.36，P =0.061）；단동계CMV감염례수점총감염례수적52.55%，동계상대교다。137례CMV감염환인중，＜2주2례（1.46%），3～12주103례（75.18%），＞12주32례（23.36%），이위생기감염거다；모유위양120례，기중족월인105례（87.50%），조산인15례（12.50%），포유기족월인CMV감염점유상당대적비례。영인거세포병독폐염상출현해수、기촉、천식、폐부라음이급발열등증상、체정，폐CT영상학진단적민감도우우X선검사。결론：CMV시인기6월령이하영인폐염적중요병원체，1～3월령적영인위역감인군。영인 CM V 폐염림상표현결핍특이성，혈청 CMV-IgM 항체양성시 CMV폐염적실험실진단의거，영상학진단주요의고폐 CT。
Objective:To explore the clinical characteristics of cytomegalovirus (CMV) infection in hospitalized infants under 6 months with pneumonia in Jining area.Methods:Eight hundred forty-eight hospitalized infants under 6 months of age with pneumonia from January 2010 to December 2012, were enrolled in our study. Serum samples were detected for CMV-IgM by ELISPOTS.Results:One hundred thirty-seven (16.16 %) were positive for CMV-IgM in 848 cases. There was no significant difference of infection rates between male (17. 11%) and female (13.75%) (χ2 =1.43,P =0.23). The infection rates of 0-1 month old, 1-3 months old, 3-5 months old and 5-6 months old were 9.57%, 28.16%, 11.17% and 10.89%, respectively. Furthermore, the age group analysis of CMV positive children with pneumonia manifested a significant increase in the infection rate among the age group of 1-3 months(χ2 =43.99,P<0.01). The rates of CMV infection were 14.19% in the spring, 12.23%, in summer, 13.30% in autumn and 20.11% in winter, with no significant difference of infection rates among seasons (χ2 =7.36,P =0.061), but the cases of infection during winter accounted for 52.55% of the total infected cases. Of the 137 infant patients with CMV infection, 2 cases(1.46%)were < 2 weeks of age , while 103 cases(75.18%) were between 3 and 12 weeks of age, and 32 cases(23.36%)were >12 weeks of age. The proportion of full-term infants breastfed was 87.50% and the one of premature infants breastfed was 12.50% in 120 cases of CMV infection. Most of the patients appear cough, short breath, rale and fever. The sensitivity of lung CT to diagnose the pneumonia was superior to chest X-ray.Conclusions:CMV was the most important viral pathogens on pneumonia in infants under 6months. Infants aged 1-3 months were susceptible to CMV infection. Clinical manifestations of infant CMV pneumonia lack specificity. The presence of serum CMV-IgM antibody is a laboratory diagnostic evidence. The iconographic diagnosis of CMV pneumonia was mainly based on lung CT.
