CAJ | 학술논문

目的探讨利用唾液标本,采用聚合酶链反应技术筛查新生儿先天性巨细胞病毒(cytomegalovirus,CMV)感染的可行性及感染患儿的临床表现. 方法 2010年11月1日至2012年2月29日,南京医科大学附属常州妇幼保健院出生的6733例新生儿出生3d内采集唾液标本0.2ml,采用实时荧光定量-聚合酶链反应技术检测唾液中CMV DNA,采用手持式EroScan瞬态耳声发射仪筛查听力.计算新生儿先天性CMV感染筛查阳性率,总结筛查阳性患儿的临床表现.统计学分析采用卡方检验. 结果 6733例新生儿接受筛查,筛查阳性率为1.59％(107/6733).其中88例(82.2％,88/107)为无症状感染,19例(17.8％,19/107)为症状性感染.19例症状性CMV感染患儿主要临床表现包括病理性黄疸13例,肝脏肿大合并肝功能异常5例,粒细胞减少、血小板减少性紫癜、贫血和小于胎龄儿各2例.14例患儿有1项临床表现,3例患儿同时合并2项临床表现,2例患儿同时合并3项临床表现.CMV筛查阳性患儿听力筛查单耳未通过者占8.4％(9/107),双耳未通过者占3.7％(4/107),与CMV筛查阴性患儿[分别为5.8％(382/6626)和2.4％(159/6626)]相比,差异没有统计学意义(x2=2.776,P=0.241). 结论利用唾液标本筛查先天性CMV感染是可行的.
목적 탐토이용타액표본,채용취합매련반응기술사사신생인선천성거세포병독(cytomegalovirus,CMV)감염적가행성급감염환인적림상표현. 방법 2010년11월1일지2012년2월29일,남경의과대학부속상주부유보건원출생적6733례신생인출생3d내채집타액표본0.2ml,채용실시형광정량-취합매련반응기술검측타액중CMV DNA,채용수지식EroScan순태이성발사의사사은력.계산신생인선천성CMV감염사사양성솔,총결사사양성환인적림상표현.통계학분석채용잡방검험. 결과 6733례신생인접수사사,사사양성솔위1.59％(107/6733).기중88례(82.2％,88/107)위무증상감염,19례(17.8％,19/107)위증상성감염.19례증상성CMV감염환인주요림상표현포괄병이성황달13례,간장종대합병간공능이상5례,립세포감소、혈소판감소성자전、빈혈화소우태령인각2례.14례환인유1항림상표현,3례환인동시합병2항림상표현,2례환인동시합병3항림상표현.CMV사사양성환인은력사사단이미통과자점8.4％(9/107),쌍이미통과자점3.7％(4/107),여CMV사사음성환인[분별위5.8％(382/6626)화2.4％(159/6626)]상비,차이몰유통계학의의(x2=2.776,P=0.241). 결론 이용타액표본사사선천성CMV감염시가행적.
Objective To investigate the feasibility of congenital cytomegalovirus (CMV)infection screening by saliva polymerase chain reaction.Methods From November 1,2010 to February 29,2012,6733 newborns born in Changzhou Maternal and Child Health Care Hospital were enrolled.Saliva samples (0.2 ml) were collected within 3 days after birth,CMV-DNA was detected by real time-polymerase chain reaction and hearing screening was done with EroScan transient-evoked otoacoustic emissions at the same time.The positive rate of congenital CMV infection screening was calculated and clinical manifestations were analyzed.Chi square test was applied to statistical analysis.Results Totally 6733 newborns were screened and 107 of them were found to be positive with CMV DNA,the positive rate was 1.59％ (107/6733),among which 88 were asymptomatic (82.2％) and 19 were symptomatic (17.8 ％).The major clinical manifestations of the neonates with positive CMVDNA were pathological jaundice (13 cases),hepatomegaly (5 cases),granulocytopenia,thrombocytopenic purpura,anemia and small for gestational age (two cases each).Fourteen newborns had only one major clinical manifestation,three newborns had two major clinical manifestations and two newborns had three major clinical manifestations.There was no statistical difference between newborns with positive and negative CMV DNA on hearing screening [hearing loss in one ear:8.4％ (9/107) vs 5.8％ (382/6626); hearing loss in two ears:3.7 ％ (4/107) vs 2.4 ％ (159/6626),x2 =2.776,P=0.241].Conclusion It is feasible to screen congenital CMV infection with saliva sample.