[1]冉丽红,包蕾.早产儿经母乳获得性巨细胞病毒感染情况及随访观察[J].第三军医大学学报,2018,40(10):939-944.
 RAN Lihong,BAO Lei.Infection status and follow-up observation for acquiring cytomegalovirus infection via breast milk among premature infants[J].J Third Mil Med Univ,2018,40(10):939-944.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第10期
页码:
939-944
栏目:
临床医学
出版日期:
2018-05-30

文章信息/Info

Title:
Infection status and follow-up observation for acquiring cytomegalovirus infection via breast milk among premature infants
作者:
冉丽红包蕾
重庆医科大学附属儿童医院,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室
Author(s):
RAN Lihong BAO Lei

Department of Neonatology, Key Laboratory of Child Development and Disorders of Ministry of Education, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, the Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China
 

关键词:
巨细胞病毒获得性感染早产儿母乳随访
Keywords:
cytomegalovirus acquired infections premature infant breast milk follow-up
分类号:
R195.4;R512.99;R722
文献标志码:
A
摘要:

目的    探讨早产儿母亲母乳存在明确的巨细胞病毒(cytomegalovirus,CMV)感染证据时,早产儿经母乳获得性CMV感染情况及短期预后。方法    收集2015年9月至2016年12月本院新生儿科住院的早产儿113例,其中37例经母乳获得性CMV感染(感染组),76例未感染(对照组)。分析CMV感染的发病率、相关临床表现及随访半年时的情况。结果   新鲜母乳喂养的早产儿中有32.7%(37/113)感染CMV,其中51.4%(19/37)的感染患儿有临床表现。感染组早产儿血小板减少症、转氨酶升高、肝脾肿大及新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)的发生率高于对照组[18.9%(7/37) vs 1.3%(1/76),29.7%(11/37) vs 13.2%(10/76),10.8%(4/37)vs 0.0%(0/76),27.0%(10/37) vs 9.2%(7/76),P<0.05]。感染组中有症状患儿胎龄、出生体质量均小于无症状患儿[31.3(25.6~35.7)周 vs 33.4(31.1~36.3)周,(1.5±0.5)kg vs (1.9±0.3)kg,P<0.05]。随访半年,感染组与对照组患儿体格发育、神经发育及听力损害情况差异均无统计学意义(P>0.05)。结论    CMV DNA阳性新鲜母乳喂养的早产儿经母乳获得性CMV感染率较高,但其短期预后较好。

Abstract:

Objective    To investigate the infection status of breast milk transmitted cytomegalovirus (CMV) and shortterm prognosis among premature infants when their mothers’ milk were positive to CMV. Methods    A total of 113 premature infants admitted in our department from September 2015 to December 2016 were enrolled in this study. There were 37 infected infants with breast milk transmitted CMV and 76 control infants. The incidence, clinical manifestations, and short-term outcome of 6 months were analyzed. Results    Postnatal CMV infection was observed in 32.7 % (37/113) of premature infants who were fed fresh breast milk. CMV infection was symptomatic in 51.4% (19/37) of the infected cases. When compared with the control infants, these infected infants had significantly higher incidence rates of thrombocytopenia, aminotransferase elevation, hepatomegaly, and neonatal necrotizing enterocolitis (NEC) [18.9% (7/37) vs 1.3% (1/76), 29.7% (11/37) vs 13.2% (10/76), 10.8% (4/37) vs 0.0% (0/76), 27.0% (10/37) vs 9.2% (7/76), P<0.05], and obviously shorter gestational age and lower birth weight [31.3 (25.6~35.7) vs 33.4 (31.1~36.3) weeks, 1.5±0.5 vs 1.9±0.3 kg, P<0.05]. During the 6 months’ follow-up, no statistical differences were found in growth status, neurodevelopmental outcome and hearing impairment between the 2 groups (P>0.05). Conclusion    The infants fed with CMV positive breast milk have higher incidence of breast milk-acquired CMV infection, but they have good short-term prognosis.
 

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更新日期/Last Update: 2018-05-30