CAJ | 학술논문

目的探讨先天性巨细胞病毒感染(cytomegalovirus,CMV)的早产儿1岁前发生的相关并发症及生长发育情况.方法先天性CMV感染早产儿58例及对照组60例早产儿进行了为期1年的前瞻性随访,其随访期内容包括:体格检查、肝功能、头颅B超、脑干听觉诱发电位(auditory brainsem response,ABRs).比较两组早产儿生长发育及相关并发症发生情况的差异.结果观察组早产儿肝炎综合征和早产儿脑病、感音神经性耳聋(sensorineural hearing loss,SNHL)的发生率高于对照组[22.41％ (13/58) vs 8.33％ (5/60),60.34％ (35/58) vs 25.00％ (15/60),36.21％ (21/58) vs13.33％(8/60),x2=4.52,P＜0.05;x2 =15.09,12.71,P＜0.01].体格发育迟缓率与对照组比较差异无统计学意义(P＞0.05).观察组3、6个月肝功能异常率(x2 =8.33、17.28,P＜0.01),出生时、3个月头颅B超异常率(x2 =15.09,P＜0.01;x2=5.38,P＜0.05),3、6个月ABRs的异常率均高于对照组(x2=17.01、8.04,P＜0.01).结论先天性CMV感染的早产儿更易合并肝炎综合征、早产儿脑病及SNHL.对此患儿应进行肝功能、头颅B超及ABRs的定期检测,可早期发现患儿的异常情况,并及时进行有效干预,能改善患儿预后.
목적 탐토선천성거세포병독감염(cytomegalovirus,CMV)적조산인1세전발생적상관병발증급생장발육정황.방법 선천성CMV감염조산인58례급대조조60례조산인진행료위기1년적전첨성수방,기수방기내용포괄:체격검사、간공능、두로B초、뇌간은각유발전위(auditory brainsem response,ABRs).비교량조조산인생장발육급상관병발증발생정황적차이.결과 관찰조조산인간염종합정화조산인뇌병、감음신경성이롱(sensorineural hearing loss,SNHL)적발생솔고우대조조[22.41％ (13/58) vs 8.33％ (5/60),60.34％ (35/58) vs 25.00％ (15/60),36.21％ (21/58) vs13.33％(8/60),x2=4.52,P＜0.05;x2 =15.09,12.71,P＜0.01].체격발육지완솔여대조조비교 차이무통계학의의(P＞0.05).관찰조3、6개월간공능이상솔(x2 =8.33、17.28,P＜0.01),출생시、3개월두로B초이상솔(x2 =15.09,P＜0.01;x2=5.38,P＜0.05),3、6개월ABRs적이상솔균고우대조조(x2=17.01、8.04,P＜0.01).결론 선천성CMV감염적조산인경역합병간염종합정、조산인뇌병급SNHL.대차환인응진행간공능、두로B초급ABRs적정기검측,가조기발현환인적이상정황,병급시진행유효간예,능개선환인예후.
Objective To investigate correlative complication and disorders in growth of premature infants with congenital CMV infections before one year old.Methods Fifty-eight infected premature infants and sixty control premature infants were followed up prospectively for one year.The differences were compared between two groups with incidence of correlative complication.Physical growth,liver function,neurosonographic and audiologic examination were used to identify the sequelae of CMV infections.Results The numbers of infants with infantile hepatitis syndrome,encephalopathy of premature infant and SNHL were significantly higher in infected group than in control group(x2 =4.52,15.09,12.71,P ＜0.05).No difference between groups was found on physical growth.However,the significant difference between two groups was observed on abnormal for liver function of 3 and 6 months(x2 =8.33,17.28,P ＜ 0.05),neurosonographic after birth and 3 months(x2 =15.09,5.38,P ＜0.05),audiologic examination of 3 and 6 months(x2 =17.01,8.04,P ＜ 0.05).Conclusions These data suggest that congenital CMV infections may be associated with hepatitis syndrome,encephalopathy of premature infant and SNHL in premature infants.Liver function,neurosonograpphic imaging and ABRs were useful in the evaluation of the premature infants with congenital CMV infections.