CAJ | 학술논문

目的研究婴儿巨细胞病毒（CMV）肝炎治疗前后血 T 细胞亚群和尿 CMV DNA 的变化及临床意义。方法选择 CMV 肝炎患儿46例，CMV 无症状性感染患儿20例，健康查体婴儿20例，比较3组间尿 CMV DNA 含量和血 T 细胞亚群的差异。比较46例 CMV 肝炎患儿治疗前后血 T 细胞亚群和尿 CMV DNA 的水平。结果CMV 肝炎患儿组尿 CMV DNA 含量明显高于 CMV 无症状性感染组和健康对照组，差异有统计学意义（t ＝2．375、P ＜0．05；t ＝16．27、P ＜0．01）。CMV 肝炎患儿组 CD4＋ T 淋巴细胞的水平和 CD4＋/CD8＋ T 淋巴细胞的比值较无症状性感染组和健康对照组均降低，CD8＋ T 淋巴细胞水平较其他组升高，差异有统计学意义。CMV 肝炎患儿抗病毒治疗后，尿 CMV DNA 含量明显下降，CD4＋ T 淋巴细胞的水平和 CD4＋/CD8＋ T 淋巴细胞的比值较治疗前升高，差异有统计学意义， CD8＋ T 淋巴细胞水平较治疗前明显下降，差异有统计学意义。结论CMV 肝炎患儿细胞免疫功能受损。抗 CMV 治疗能有效改善患儿的细胞免疫功能，治疗前后监测血 T 细胞亚群和尿 CMV DNA 变化对判断预后和指导临床治疗有重要意义。
목적연구영인거세포병독（CMV）간염치료전후혈 T 세포아군화뇨 CMV DNA 적변화급림상의의。방법선택 CMV 간염환인46례，CMV 무증상성감염환인20례，건강사체영인20례，비교3조간뇨 CMV DNA 함량화혈 T 세포아군적차이。비교46례 CMV 간염환인치료전후혈 T 세포아군화뇨 CMV DNA 적수평。결과CMV 간염환인조뇨 CMV DNA 함량명현고우 CMV 무증상성감염조화건강대조조，차이유통계학의의（t ＝2．375、P ＜0．05；t ＝16．27、P ＜0．01）。CMV 간염환인조 CD4＋ T 림파세포적수평화 CD4＋/CD8＋ T 림파세포적비치교무증상성감염조화건강대조조균강저，CD8＋ T 림파세포수평교기타조승고，차이유통계학의의。CMV 간염환인항병독치료후，뇨 CMV DNA 함량명현하강，CD4＋ T 림파세포적수평화 CD4＋/CD8＋ T 림파세포적비치교치료전승고，차이유통계학의의， CD8＋ T 림파세포수평교치료전명현하강，차이유통계학의의。결론CMV 간염환인세포면역공능수손。항 CMV 치료능유효개선환인적세포면역공능，치료전후감측혈 T 세포아군화뇨 CMV DNA 변화대판단예후화지도림상치료유중요의의。
Objective To study the changes and significance of CMV-DNA in urine and T cell subsets in blood of infants Infant Cytomegalovirus Hepatitis.Methods 46 infants with Cytomegalovirus Hepatitis were selected in this study,20 asymptomatic infants who were confirmed infected by CMV and 20 infants who received health examination served as controls.The CMV-DNA in urine and T cell subsets in blood were detected and were compared in three groups. Detect CMV-DNA and T cell subsets in blood in 46 infants with Cytomegalovirus Hepatitis after treatment again ,the level of CMV-DNA and T cell subsets after treatment were compared with before treatment.Results The urine DNA level in infants with Cytomegalovirus Hepatitis was higher than that in the asymptomatic and healthy controls.Blood levels of CD3 + ,CD4 + and CD4 +/CD8 + in the Cytomegalovirus Hepatitis group were lower than that in the asymptomatic and healthy controls,while the levels of CD8 + were higher.After treatment,the urine DNA level and the levels of CD8+were significantly lower,while the levels of CD3 + ,CD4 + and CD4 +/CD8 + were significantly higher.Conclusion Cellular immunity was damaged in infants with Cytomegalovirus Hepatitis,the function of T helper cells is low,while suppressor T cells are in a hyperfunctional state.Anti-virus therapy can effectively improve the cellular immunity of infants with Cytomegalovirus Hepatitis.Monitor the changes of CMV-DNA in urine and blood T cell subsets after and before treatment,which is of significance in prediction of prognosis and in guidance of clinical therapy for this condition.