發(fā)布時間：2018-03-19 04:01

  本文選題：巨細胞病毒　切入點：更昔洛韋　出處：《中華全科醫(yī)學(xué)》2016年07期 　論文類型：期刊論文

【摘要】：目的研究更昔洛韋治療對Connexin26基因突變的巨細胞病毒感染嬰兒聽力的影響,并了解是否可以逆轉(zhuǎn)此類嬰兒的聽力損害情況。方法從溫州醫(yī)科大學(xué)附屬第二醫(yī)院及金華永康市第一人民醫(yī)院篩選血和尿液CMV-DNA陽性嬰兒,根據(jù)人Connexin26基因編碼區(qū)核苷酸全序列,進行RT-PCR檢測,獲得產(chǎn)物繼續(xù)堿基測序,存在基因突變的巨細胞病毒感染嬰兒70例作為研究對象。根據(jù)血生化結(jié)果,將肝功能損害的嬰兒列為Ⅰ組(22例,進行更昔洛韋治療),將無肝功能損害的嬰兒隨機分為更昔洛韋治療組(Ⅱ組,24例)和非更昔洛韋治療組(Ⅲ組,24例),更昔洛韋的治療為誘導(dǎo)期劑量為每次5 mg/kg,每12 h一次,持續(xù)14 d,此后改為1次/d維持治療,劑量同前,持續(xù)7 d,復(fù)查肝功能及CMV-DNA拷貝數(shù),檢測并追蹤患兒治療前后腦干聽覺誘發(fā)電位變化,比較各組肝功能指標、CMV-DNA拷貝數(shù)及腦干誘發(fā)電位結(jié)果。結(jié)果經(jīng)過更昔洛韋治療,Ⅰ組嬰兒肝功能異常情況明顯好轉(zhuǎn)(ALT:t=8.610 9,P0.000 1;AST:t=15.007 7,P0.000 1;TBil:t=10.993 3,P0.0001),Ⅰ組和Ⅱ組CMV-DNA拷貝數(shù)明顯下降(t=5.460 4,P0.000 1),但BAEP檢測異常的嬰兒聽力損害情況沒有好轉(zhuǎn),部分患兒呈惡化趨勢,而Ⅲ組嬰兒聽力損害情況無明顯變化。結(jié)論更昔洛韋治療對巨細胞病毒感染所致肝炎等炎癥性疾病有效,但對感音性神經(jīng)性聾,特別是有Connexin26基因突變的聽力損害無效。
[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，

本文編號：1632703