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人巨细胞病毒(HCMV)是引起婴儿病毒性肝炎的主要病原之一。病毒感染可发生于胎儿期或生后任一时期,按临床表现轻重分为无症状型、无黄疸型、急性黄疸型和急性淤胆型。长期以来,对婴儿HCMV肝炎治疗,尤其是是否需要分型区别治疗缺乏统一方案。我们根据临床症状轻重不同,探讨对不同分型采用不同治疗方案的疗效。一、资料与方法 1．病例选择：41例HCMV患者为2002年2月-2005年8 月在青岛市妇女儿童医疗保健中心住院治疗的患儿。所有病例都有肝功能异常,血清HCMV DNA载量＞10~3拷贝／ml,血清 HCMV-lgM阳性或阴性,同时除外胆道系统畸形、代谢性肝病、药物中毒性肝炎、甲型肝炎、乙型肝炎和丙型肝炎。按临床特点及肝功能结果分为无黄疸型组[粪便色正常,直接胆红素 (DBil)＜25．65μmol／L,A组]和急性淤胆型组[粪便色变浅, DBil＞25．65μmol／L且占总胆红素(TBil)20％以上,B组], 其中A组25例,B组16例。
Human cytomegalovirus (HCMV) is one of the major causative agents of infant viral hepatitis. Virus infection can occur in either period of fetal or postnatal period, according to the clinical manifestations of severity is divided into asymptomatic, jaundice-free, acute jaundice and acute cholestasis. For a long time, there is a lack of a unified solution to the treatment of hepatitis with HCMV in infants, especially whether or not the treatment is needed. According to the severity of clinical symptoms we explore different types of treatment with different efficacy of the program. First, data and methods 1. Case Selection: 41 patients with HCMV were hospitalized in Qingdao Women’s and Children’s Medical Center from February 2002 to August 2005. All cases had liver dysfunction, serum HCMV DNA load> 10 ~ 3 copies / ml, serum HCMV-lgM positive or negative, except biliary system malformations, metabolic liver disease, drug toxic hepatitis, hepatitis A, B Hepatitis and Hepatitis C According to the clinical features and liver function results were divided into jaundice group [normal stool color, direct bilirubin (DBil) <25.65μmol / L, A group] and acute cholestasis group [stool color becomes lighter, DBil> 25 .65μmol / L and accounting for more than 20% of total bilirubin (TBil), group B], including 25 cases in group A and 16 cases in group B.