本文選題：巨細(xì)胞病毒　切入點(diǎn)：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(duì)Connexin26基因突變的巨細(xì)胞病毒感染嬰兒聽(tīng)力的影響,并了解是否可以逆轉(zhuǎn)此類嬰兒的聽(tīng)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(yáng)性嬰兒,根據(jù)人Connexin26基因編碼區(qū)核苷酸全序列,進(jìn)行RT-PCR檢測(cè),獲得產(chǎn)物繼續(xù)堿基測(cè)序,存在基因突變的巨細(xì)胞病毒感染嬰兒70例作為研究對(duì)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(jìn)行更昔洛韋治療),將無(wú)肝功能損害的嬰兒隨機(jī)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(cè)并追蹤患兒治療前后腦干聽(tīng)覺(jué)誘發(fā)電位變化,比較各組肝功能指標(biāo)、CMV-DNA拷貝數(shù)及腦干誘發(fā)電位結(jié)果。結(jié)果經(jīng)過(guò)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(cè)異常的嬰兒聽(tīng)力損害情況沒(méi)有好轉(zhuǎn),部分患兒呈惡化趨勢(shì),而Ⅲ組嬰兒聽(tīng)力損害情況無(wú)明顯變化。結(jié)論更昔洛韋治療對(duì)巨細(xì)胞病毒感染所致肝炎等炎癥性疾病有效,但對(duì)感音性神經(jīng)性聾,特別是有Connexin26基因突變的聽(tīng)力損害無(wú)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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