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目的观察更昔洛韦治疗新生儿先天性症状性巨细胞病毒(CMV)感染的临床效果。方法选取2013年1月至2015年12月新乡市中心医院新生儿科收治的先天性症状性CMV感染且脑脊液(CSF)CMV DNA阳性的90例患儿,随机分为治疗组(更昔洛韦治疗,45例)与对照组(常规对症支持治疗,45例)。应用PCR法检测两组患儿治疗前后CSF CMV DNA载量,并于出生1个月内进行听力筛查、生后6个月及1 a行脑干听觉诱发电位检测。结果治疗前两组CSF CMV DNA载量比较,差异无统计学意义(P>0.05);治疗组治疗后CSF CMV DNA载量、听力筛查阳性率、听力损伤率均较对照组低[分别为:(1.17±0.56)比(3.35±0.68),77.8%比84.4%,66.7%比80.0%],差异均有统计学意义(P<0.05)。结论更昔洛韦治疗新生儿先天性症状性CMV感染,有效降低了脑脊液巨细胞病毒载量和患儿听力损伤率,治疗效果较好,值得临床推广应用。
Objective To observe the clinical effect of ganciclovir in the treatment of neonatal congenital symptomatic cytomegalovirus (CMV) infection. Methods 90 children with congenital symptomatic CMV infection and CMV DNA positive from cerebrospinal fluid (CSF) admitted to neonatology department of Xinxiang Central Hospital from January 2013 to December 2015 were randomly divided into treatment group (ganciclovir treatment , 45 cases) and control group (conventional symptomatic and supportive treatment, 45 cases). The CSF CMV DNA load was measured by PCR before and after treatment. Hearing screening was performed within 1 month after birth. Brainstem auditory evoked potentials were measured at 6 months and 1 year after birth. Results There was no significant difference in CSF CMV DNA load between the two groups before treatment (P> 0.05). The CSF CMV DNA load, hearing screening positive rate and hearing loss rate in the treatment group were lower than those in the control group [ : (1.17 ± 0.56) vs (3.35 ± 0.68), 77.8% vs 84.4%, 66.7% vs 80.0%, respectively], the difference was statistically significant (P <0.05). Conclusion Ganciclovir treatment of congenital symptomatic CMV infection in neonates, effectively reducing the cerebrospinal fluid cytomegalovirus viral load and hearing loss in children, the treatment effect is good, worthy of clinical application.