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目的研究巨细胞病毒(CMV)感染患儿的听力损伤情况,探讨更昔洛韦治疗婴儿CMV感染的疗效。方法将68例CMV感染婴儿分为治疗组(38例,加用更昔洛韦)与对照组(30例,仅用护肝利胆等对症治疗)。治疗前后进行尿CMV-DNA及脑干听觉诱发电位(BAEP)检测。结果治疗组治疗后尿CMV-DNA阴转率高于对照组(P<0.05)。BAEP测试:与对照组相比,治疗后除了Ⅲ-V波峰间期(IPL)外各波潜伏期(PL)及IPL均较前减少(P<0.05)。Ⅴ波听反应阈:治疗组治疗后听力损伤率(13.1%)低于对照组(26.6%)(P<0.05)。结论 BAEP检测可早期发现CMV感染患儿听力障碍的程度和性质。加用更昔洛韦治疗近期可减少尿中CMV排毒及消除病毒血症,远期可降低听力异常的发病率。
Objective To study the hearing impairment of children with cytomegalovirus (CMV) infection and to investigate the curative effect of ganciclovir on infants with CMV infection. Methods Sixty-eight infants with CMV infection were divided into treatment group (n = 38) and ganciclovir (n = 30), and control group (n = 30). Urine CMV-DNA and brainstem auditory evoked potentials (BAEP) were measured before and after treatment. Results After treatment, the urinary CMV-DNA negative conversion rate of the treatment group was higher than that of the control group (P <0.05). Compared with the control group, the BAEP test showed that the PL and IPL of each wave were significantly lower than those before (P <0.05) except for the III-V peak interval (IPL). Ⅴ wave listening response threshold: The treatment group hearing loss rate (13.1%) was lower than the control group (26.6%) (P <0.05). Conclusion The detection of BAEP could detect the degree and the nature of hearing impairment in children with CMV infection early. Addition of ganciclovir can shorten the treatment of CMV detoxification and viremia in the urine in the near future, and can reduce the incidence of abnormal hearing in the long run.