摘要
目的探讨婴儿巨细胞病毒(CMV)肺炎的临床特点及诊治方法。方法选取2005年5月至2006年7月于中国医科大学附属盛京医院小儿呼吸科住院的年龄1个月至1岁肺炎患儿60例,以血清CMVIgM抗体(CMV-IgM)阳性及尿CMV-DNA定量阳性的40例肺炎患儿为观察组;以CMV-IgM及尿CMV-DNA定量均阴性的20例肺炎患儿为对照组;将两组临床资料进行对比分析。结果观察组较对照组在咳嗽、喘息、呼吸困难的临床表现方面差异无统计学意义(P>0.05);观察组肺部的喘鸣音和水泡音等体征少于对照组,差异有统计学意义(P<0.05)。CMV肺炎的影像学诊断主要依靠肺CT,其敏感度为100%,而肺计算机X线摄影(CR)仅为29.4%。观察组中30例患儿予以更昔洛韦治疗,10例未用;更昔洛韦治疗组22例治愈,治愈率73.3%;未应用更昔洛韦组治愈率20.0%,两组比较有统计学意义(P<0.05)。结论婴儿CMV肺炎临床表现缺乏特异性,肺部体征不典型,普通胸片不易发现炎症,容易误诊。对疑诊患儿需及时检测血清CMV-IgM及尿CMV-DNA,及时做肺CT检查;确诊后首选更昔洛韦治疗。
Objective To explore the clinical characteristics, diagnosis and treatment for infants with cytomegalovirus （CMV） pneumonia. Methods Totally 40 patients with pneumonia, 1 to 12 months, with positive serum CMV-IgM and positive uric CMV-DNA qnantitation were considered as the study group; 20 patients with pneumonia, 1 to 12 months, with negative serum CMV-IgM and negative uric CMV-DNA quantitation were considered as the control group in the same period. The clinical data were compared between the two groups, so as to evaluate the clinical characteristics, diagnosis and therapeutic effects of CMV pneumonia in infants. Results No significant difference was detected between the study group and the control group concerning cough, gasp and dyspnea（P 〉 0.05）, while the main signs of lung had significant difference between them （P 〈 0.05 ）. The iconographic diagnosis of CMV pneumonia was mainly based on lung CT, with a sensitivity of 100%, while the diagnosis sensitivity of the lung CR was 29.4%. Thirty children in the study group were treated with ganciclovir, and among these patients, 22 were cured （ cure rate was 73.3 % ）, and the cure rate of the group without GCV treatment was 20.0 % （P 〈 0.05）. Conclusion The diagnosis of CMV pneumonia in infants is difficult for there is no specificity in clinical manifestation and signs of lung. The sensitivity of lung CT to diagnose the pneumonia was superior to lung CR. The serum CMV-IgM, uric CMV-DNA and lung CT are essential for the patients with CMV pneumonia. The effective medicine for treatment is GCV.
出处
《中国实用儿科杂志》
CSCD
北大核心
2010年第8期625-627,共3页
Chinese Journal of Practical Pediatrics
关键词
婴儿
巨细胞病毒
肺炎
更昔洛韦
infant
cytomegalovirus
pneumonia
ganciclovir
