摘要
目的 分析有症状的婴儿巨细胞病毒(CMV)感染引起的感音神经性耳聋(SNHL)发生率,脑干听觉诱发电位(BAEP)结果与临床特征相关性。方法 ①回顾性观察4 0例有症状婴儿CMV感染的BAEP。②分析BAEP结果与尿CMV-DNA定量(FQ -PCR法)、血清CMV -IgM抗体、谷丙转氨酶(ALT)、胆红素水平(DBIL、UDBIL)、血常规(PLT、HGB)等实验室检查及肝脾大、CMV肺炎、早产等临床症状之间的相关性。结果 有症状的CMV感染导致感音神经性耳聋的发病率更高(82 .5 % ) ,多伴有肝脾肿大(77.5 % )、肺炎(35 % )、先天性感染易合并先天畸形(32 .5 % )、血液系统受累(15 % )、早产(12 .5 % )、胆道闭锁(10 % )、抽搐(10 % ) ,病程中可并发机会致病菌败血症(7.5 % )。有症状的婴儿CMV感染听力正常和听力异常的患儿尿CMV -DNA定量之间差异显著P <0 .0 5。结论 婴儿CMV感染是导致人类非遗传性先天性耳聋的主要原因之一,有症状的婴儿CMV感染应警惕感音神经性耳聋的发生,尿CMV -DNA定量高于10 4copies/ml者应高度怀疑SNHL的发生,所有CMV感染患儿均应进行听力筛查,BAEP是早期发现CMV听路病变的敏感、非损伤性检查,值得推广。
Objective: To investigate the incidence of sensorineural hearing loss(SNHL)in children with symptomatic cytomegalovirus infection, the relevance between result of the brain stem auditory evoked potential (BAEP)and the clinical features. Methods:(1)The brain stem auditory evoked potential of 40 infants with CMV infection were studied retrospectively.(2)The relevance of serum DBIL?UDBIL, ALT, serum CMV-IgM, urine CMV-DNA, PLT, HGB and the size of liver and spleen, CMV pneumonia, prematurity with the result of BAEP was analyzed. Results: The incidence of SNHL in children with symptomatic cytomegalovirus infection is higher than noninfection (82.5%), majority of them was associated with hepatosplenomegaly (77.5%), pneumonia (35%). Patients with congential infection tended to have deformity (32.5%) blood system damage (15%), prematurity (12.5%), biliary tract obstruction (10%), seizures (10%). and sometimes combine with opportunistic infection (7.5%). There are notable difference in urine CMV-DNA titers between normal hearing and abnormal hearing children with symptomatic cytomegalovirus infection ( P <0.05). Conclusion Infant cytomegalovirus infection is one of the leading non-genetic causes of SNHL in children. The children with urine CMV-DNA titers higher than 104 copies/ml should be suspected SNHL.The hearing of all the children with CMV infection should be evaluated. BAEP is a kind of sensitive, harmless method. It can find hearing damage by CMV infection in early stage, which is worth to be popularized.
出处
《中国优生与遗传杂志》
2005年第4期108-111,共4页
Chinese Journal of Birth Health & Heredity
关键词
巨细胞病毒
脑干听觉诱发电位
耳聋
Cytomegalovirus
Brain stem auditory evoked potential
Hearing loss
