| 摘要: |
| 目的:探讨免疫正常婴儿支气管肺泡灌洗液(BALF)中检测到巨细胞病毒(CMV)-DNA,临床是否有必要行抗病毒治疗。方法:回顾性分析2010年4月至2014年4月,通过BALF检测CMV-DNA方法诊断CMV肺炎的病例,按是否给予更昔洛韦抗病毒治疗分为治疗组和对照组,比较两组临床特点和转归。结果: 43例患儿纳入研究,治疗组28例,对照组15例。两组患儿病程、喘息、外周血白细胞及淋巴细胞计数、肝功能及听力损害、血CMV-DNA阳性率、合并其他病原感染比例以及治疗后影像学和临床症状恢复情况等比较差异均无统计学意义,治疗组BALF、外周血中CMV-DNA拷贝数较高。两组共19 例(44.2%)合并
感染,肺炎支原体感染9例,呼吸道合胞病毒感染6例,其它感染4例。治疗组临床好转率85.7%,对照组临床好转率93.3%, 两组比较差异无统计学意义(P>0.05)。结论:免疫功能正常婴儿的BALF中检测到CMV-DNA有可能为潜伏感染,不一定需要抗病毒治疗,临床应避免过度治疗。CMV-DNA拷贝数高低与是否进行治疗的关系有待进一步探讨。 |
| 关键词: 巨细胞病毒 肺炎 支气管肺泡灌洗液 免疫功能 婴儿 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2017.02.002 |
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| 基金项目:深圳市医学重点专科项目资助,编号2005C05 |
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| Necessity of Positive Result of Cytomegalovirus DNA Testing in Bronchoalveolar Lavage Fluid and Antiviral Treatment to Normal Immunocompetent Infants |
| Chen Jiehua, Zheng Yuejie, Ma Hongling, Wang Wenjian, Sun Jie |
| (Shenzhen Children's Hospital, Guangdong Shenzhen 518026, China) |
| Abstract: |
| Objective: To investigate the necessity of antiviral treatment to normal immunocompetent infants with Cytomegalovirus DNA (CMV-DNA) testing in bronchoalveolar lavage fluid (BALF). Methods: Retrospective analyzed the clinical data of CMV pneumonia diagnosed by CMV-DNA quantitative detection in BALF from April 2010 to April 2014. All children were divided into treatment group and control group according to the prescription of ganciclovir. The clinical features and prognosis were compared. Results: Forty three
cases were recruited, with 28 in treatment group and 15 in control group. There were no statistical differences in course of disease, rate of wheezing, white blood cell and lymphocyte count, rate of hypohepatia and hearing impairment, positive rate of CMV-DNA in serum, rate of co-infections and the prognosis of symptom and imaging. The copies of CMV-DNA in BALF and blood were higher in treatment group. There were total 19 cases (44.2%) were co鄄infections, nine with Mycoplasma pneumoniae and 6 with Respiratory syncytial virus. The clinical amelioration rate were 85.7% in treatment group and 93.3% in control group (P>0.05). Conclusion: Positive CMV-DNA in BALF of normal immunocompetent infants could be latent infection, antiviral is not necessary for these cases. Over treatment should be avoided. The implication of the quantity of CMV-DNA and the necessity of antiviral need further studies. |
| Key words: Cytomegalovirus pneumonia bronchoalveolar lavage fluid immune function infants |
