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題名 | Perinatal cytomegalovirus infection in very low birth weight infants=極低出生體重嬰兒的周產期巨細胞病毒感染 |
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作者 | 鄒國英; 李榮仁; 鍾泰榮; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 30:6 民78.11-12 |
頁次 | 頁394-400 |
分類號 | 417.5171 |
關鍵詞 | 極低出生體重嬰兒; 周產期巨細胞病毒感染; |
語文 | 英文(English) |
中文摘要 | 隨著新生兒學的進步,出生體重不足1500公克嬰兒的存活率增加,因而屬於這羣極低體重嬰兒所特有的一些問題漸爲人所重視。爲了瞭解周産期巨細胞病毒(CMV)感染在極低出生體重兒的發生率、致病情形、及輸血所扮演的角色,本研究針對89例沒有先天性CMV感染的極低出生體重兒做一前瞻性的研究。94%的嬰兒在出生時即有來自母親的CMV IgG抗體。依嬰兒是否曾接受過輸血而分成兩組:輸血組和非輸血組。有52例嬰兒完成此研究,輸血組30例,非輸血組22例;兩組嬰兒在出生體重、懷孕週數、性別和生産方式方面均沒有差異,而輸血組的嬰兒均較病重,致病及後遺症的發生率均較高。少量輸血的血液均直接自已做過篩檢的捐血者抽出,待沉積1-2小時後排出多餘的血漿,然後輸入嬰兒體內。輸血組的嬰兒平均輸血52.3±42.6C. C(10-177C. C.),來自2.3±1.3個(1-5個)供血者。95%的供血者為CMV IgG陽性,23個供血者有做CMV IgM的檢驗,其中2個為陽性。52例嬰兒中有20例(38.5%)得到周産期CMV感染,輸血組的感染率較非輸血組為高(50.0%對22.7%), P<0.05。輸血組有7例,非輸血組有1例嬰兒,在出現結合型高黃膽症或肝炎時,小便培養分離出CMV。在母親為CMV IgG陽性的嬰兒,以CMV血清陽性的血輸血,此和周産期CMV感染的關係尚需進一步的研究。 |
英文摘要 | With the improvement in the survival of very low birth weight (VLBW, birth weight less than 1500gm) infants, problems specifically related to this weight group infants have been revealed. To define the incidence, morbidity and the possible role of blood transfusion of perinatally acquired cytomegalovirus (CMV) infection, 89 VLBW infants who had no evidence of congenital CMV infection were enrolled in a prospective study. 94% of the 82 infants tested had transplacental CMV IgG antibody at birth. According to the need of blood transfusion, Infants were divided into two groups: transfusion group (TF group) and nontransfusion group (NT group). Fifty two cases finished the study, thirty cases in the TF group, twenty-two cases in the NT group, and were subjected to the final analysis. Infants in this two groups wre compatible in birth weight, gestational age, sex and mode of delivery. Infants in the TF group were sicker and had higher incidence of morbidity. Infants in the TF group received fresh blood from walking donors for small amount of blood transfusion. Each infant received an average of 52.3±42.6 ml blood from 2.3±1.3 donors. Ninty-five percent of the blood donors were CMV seropositive. Twenty out of the 52 (38.5%) VLBW infants developed perinatal CMV infection. Higher rate of perinatal CMV infection was found in the TF group (50.0%), comparing with the NT group (22.7%), p<0.05. More infants with low maternal antibodies at birth got perinatal CMV infection than infants with high maternal antibodies (47.6vs 20%). Yet, the difference didn't reach statistical significance (p>0.05, <0.1). Seven out of 15 infected infants in the TF group and one out of 5 in the NT group had symptoms and signs of conjugated hyperbilirubinemia or hepatitis at the time of virus isolation. The role of transfusion of seropositive blood to infants of seropositive mother in the perinatally acquired CMV infection need further study. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。