【摘要】 目的分析巨细胞病毒(CMV)感染致婴儿肝炎综合征(IHS)患儿血氨水平与肝功能指标之间的相关性,探讨血氨水平对评估CMV感染致IHS病情的临床价值。方法选取130例IHS患儿作为研究组,同期选取健康体检的130例婴儿作为对照组。采用化学发光法测定两组婴儿血清CMV-IgM水平,采用荧光定量PCR测定尿HCMV-DNA;采用全自动生化分析仪检测52例CMV感染致IHS患儿的血氨及肝功能指标,并分析血氨与肝功能水平的相关性。随访12月,观察CMV感染与治疗后复发率的关系。结果研究组的血清CMV-IgM阳性率为36.15%,尿HCMV-DNA阳性率为40.0%,均显著高于对照组(P<0.001)。CMV感染致IHS患儿中不同血氨水平亚组各肝功能指标比较,差别均无统计学意义(P>0.05);相关分析显示,CMV感染致IHS患儿血氨水平与各肝功能指标均无相关性(P均>0.05),而与血清白蛋白(ALB)呈负相关(Pearson相关系数为-0.594,P<0.001)。CMV感染阴性的IHS复发率为3.85%,明显低于CMV感染阳性患儿的11.54%(χ2=5.686,P=0.017)。结论血氨水平联合血清ALB可以反映CMV感染致IHS患儿的病情变化,有助于CMV感染致IHS的早期诊断和治疗。更多还原

【Abstract】 Objective To analyze the correlation between blood ammonia level and liver function index in children with infantile hepatitis syndrome(IHS)caused by cytomegalovirus(CMV)infection and to explore the clinical value of blood ammonia level in assessing IHS condition caused by CMV infection.Methods 130 children with IHS were selected as the study group. In the same period,130 healthy infants from our hospital were selected as the control group. Serum CMV-IgM levels in infants of the two groups were determined by ELISA method. Urine HCMV-DNA was measured by fluorescence quantitative PCR. Blood ammonia and liver function indexes of 52 children with IHS caused by CMV infection were detected by automatic biochemical analyzer to analyze the correlation between blood ammonia and liver function levels. After the children was discharged from the hospital for an average of 12 months,the relationship between CMV infection and relapse rate after treatment was observed. Results The positive rate of serum CMV-IgM was 36.15%in the study group,and the positive rate of HCMV-DNA in the urine was 40.0%. Both positive rates were significantly higher than those in the control group(P<0.001).There was no significant difference in liver function indexes between different blood ammonia levels in children with IHS caused by CMV infection(P>0.05). Correlation analysis showed that blood ammonia levels and liver function indexes were not found in children with IHS caused by CMV infection(all P>0.05). However,there was a negative correlation with serum albumin(ALB)(Pearson correlation coefficient=0.594,P<0.001). The recurrence rate of infantile hepatitis syndrome with negative CMV infection was 3.85%,which was significantly lower than 11.54% of infants with positive CMV infection(χ2=5.686,P=0.017). Conclusion Blood ammonia level combined with serum ALB can reflect the change of condition of children with IHS caused by CMV infection,and it is helpful for the early diagnosis and treatment of children with IHS caused by CMV infection.更多还原