更昔洛韦治疗对Connexin26基因突变巨细胞病毒感染婴儿听力的影响

发布时间：2018-03-19 04:01

  本文选题：巨细胞病毒　切入点：更昔洛韦　出处：《中华全科医学》2016年07期 　论文类型：期刊论文

【摘要】：目的研究更昔洛韦治疗对Connexin26基因突变的巨细胞病毒感染婴儿听力的影响,并了解是否可以逆转此类婴儿的听力损害情况。方法从温州医科大学附属第二医院及金华永康市第一人民医院筛选血和尿液CMV-DNA阳性婴儿,根据人Connexin26基因编码区核苷酸全序列,进行RT-PCR检测,获得产物继续碱基测序,存在基因突变的巨细胞病毒感染婴儿70例作为研究对象。根据血生化结果,将肝功能损害的婴儿列为Ⅰ组(22例,进行更昔洛韦治疗),将无肝功能损害的婴儿随机分为更昔洛韦治疗组(Ⅱ组,24例)和非更昔洛韦治疗组(Ⅲ组,24例),更昔洛韦的治疗为诱导期剂量为每次5 mg/kg,每12 h一次,持续14 d,此后改为1次/d维持治疗,剂量同前,持续7 d,复查肝功能及CMV-DNA拷贝数,检测并追踪患儿治疗前后脑干听觉诱发电位变化,比较各组肝功能指标、CMV-DNA拷贝数及脑干诱发电位结果。结果经过更昔洛韦治疗,Ⅰ组婴儿肝功能异常情况明显好转(ALT:t=8.610 9,P0.000 1;AST:t=15.007 7,P0.000 1;TBil:t=10.993 3,P0.0001),Ⅰ组和Ⅱ组CMV-DNA拷贝数明显下降(t=5.460 4,P0.000 1),但BAEP检测异常的婴儿听力损害情况没有好转,部分患儿呈恶化趋势,而Ⅲ组婴儿听力损害情况无明显变化。结论更昔洛韦治疗对巨细胞病毒感染所致肝炎等炎症性疾病有效,但对感音性神经性聋,特别是有Connexin26基因突变的听力损害无效。
[Abstract]:Objective to study the effects of ganciclovir therapy on hearing of infants infected with Connexin26 gene mutation cytomegalovirus (CMV). Methods CMV-DNA positive infants in blood and urine were screened from the second affiliated Hospital of Wenzhou Medical University and the first people's Hospital of Jinhua Yongkang City. According to the nucleotide sequence of the coding region of human Connexin26 gene, they were selected from the second affiliated Hospital of Wenzhou Medical University and the first people's Hospital of Jinhua Yongkang City. 70 infants infected by cytomegalovirus with gene mutation were selected for RT-PCR detection. According to the results of blood biochemistry, 22 infants with liver function damage were classified as group 鈪，

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