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目的:分析儿童人巨细胞病毒(HCMV)肺炎的临床特征、治疗和预后特点，评价荧光定量PCR方法检测支气管肺泡灌洗液(BALF)HCMV DNA拷贝数对HCMV肺炎的诊断价值。方法:在2015年1月至2019年12月中国医科大学附属盛京医院住院患儿中，收集荧光定量PCR方法检测BALF HCMV DNA阳性的58例0~7岁患儿临床资料进行回顾性分析。根据是否存在HCMV肺部活动性感染将研究对象分为HCMV活动感染组(22例)和HCMV潜伏感染组(36例)，对HCMV肺炎的临床症状和体征、治疗及预后进行比较分析；绘制受试者工作特征(ROC)曲线评价BALF HCMV DNA定量检测对HCMV肺炎的诊断意义并确定诊断阈值。结果:(1)与HCMV潜伏感染组比较，HCMV活动感染组发病年龄更小、男性婴幼儿多见、平均住院时间延长(n P<0.05)。HCMV活动感染组中，肺部湿啰音、低氧血症发生率更高(n P<0.05)；血清谷草转氨酶、乳酸脱氢酶、肌酸激酶均高于HCMV潜伏感染组(n P<0.05)；HCMV活动感染组BALF HCMV DNA拷贝数显著高于HCMV潜伏感染组(n P<0.01)。HCMV活动感染组的治疗措施中额外给氧或机械通气、全身激素治疗比例高于HCMV潜伏感染组(n P<0.05)；HCMV活动感染组治疗结局好转出院率更低(n P<0.05)。(2)ROC曲线分析结果显示，荧光定量PCR方法检测BALF HCMV DNA诊断儿童HCMV肺炎的ROC曲线下面积是0.708，诊断阈值为8.83×10n 3 copies/mL，敏感度为77.27%，特异度为58.33%。n 结论:HCMV肺部的活动性感染即HCMV肺炎较潜伏感染更多见于男性婴幼儿，年龄更小，临床表现更严重，好转出院率较低。BALF HCMV DNA定量检测结果作为HCMV肺炎的实验室诊断指标具有临床诊断价值，诊断阈值为8.83×10n 3 copies/mL。n “,”Objective:To investigate the clinical features, therapy and prognosis of human cytomegalovirus(HCMV)pneumonia in pediatric patients, and to analyze the diagnosis value of detecting HCMV DNA in bronchoalveolar lavage fluid(BALF)by real-time PCR.Methods:The clinical characteristics of 58 pediatric inpatients who were HCMV DNA positive in BALF were retrospectively reviewed.All the patients were from Shengjing Hospital of China Medical University from January 2015 to December 2019.Clinical, radiologic, laboratory and microbiologic data was collected for each patient.The study cohort was divided into HCMV productive infection and latent infection consisting of 22 and 36 patients respectively, based on the HCMV active infection in lung or not.Receiver operating characteristic(ROC)curve was used to assess utility of detecting HCMV DNA in BALF and establish a threshold for diagnosis.Results:(1)Compared with patients in latent infection group, the children in productive infection group had a lower age of onset(n P<0.05), a higher proportion of male(n P<0.05), and more prolonged hospitalization stay(n P<0.05). Pulmonary rales, hypoxemia and higher AST, CK, LDH in serum were easier to detect in productive infection group(n P<0.05). Higher HCMV DNA copies in BALF was also detected(n P<0.01). Patients in productive infection group had significantly more exposure to additional oxygen treatment or mechanical ventilation and systemic hormone therapy(n P<0.05), while with poorer outcomes(n P<0.05). (2) ROC curve analysis showed that the AUC for HCMV DNA in BALF in diagnosis of HCMV pneumonia was 0.708 with a threshold of 8.83×10n 3 copies/mL, a sensitivity of 77.27%, and a specificity of 58.33%.n Conclusion:Those who are diagnosed HCMV pneumonia have a lower age of onset with higher male proportion.These children suffered severer clinical signs.The patients with HCMV DNA copies higher than 8.83×10n 3 copies/mL in BALF would be more likely to be diagnosed as HCMV pneumonia.n