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目的 探讨新生儿高胆红素血症与输血传播病毒 (TTV )感染的相关性及更昔洛韦的抗 TTV感染效果。 方法 将 2 2 3例高胆红素血症新生儿分成两组 :12 5例暂未发现病因为病因未明组 ;98例已找到一种或一种以上病因为病因明确组。另选择 85例无高胆红素血症的正常新生儿为正常对照组。应用巢式聚合酶链反应技术 ,对三组患儿外周血标本进行 TTV DNA扩增、电泳分析和丙氨酸氨基转移酶 (AL T)测定。对 TTV DNA阳性且 AL T异常患儿 ,随机应用更昔洛韦或病毒唑 10mg/ (kg· d)治疗 7d后 ,复查外周血 TTV DNA和 AL T。 结果 病因未明组中 ,12例外周血检测出 TTV DNA ,阳性率为 9.6 % ;病因明确组中 ,3例外周血检测出 TTV DNA,阳性率为 3.1% ;正常对照组 TTV DNA均为阴性。三组 TTV感染率差异有非常显著意义 (P<0 .0 0 1)。9例 TTV DNA阳性和血清 AL T异常患儿中 ,5例使用更昔洛韦治疗 7d后 ,外周血 TTV DNA全部转阴 ,AL T于治疗2周内恢复正常 ;4例使用病毒唑治疗 2周后 ,外周血 TTV DNA仍为阳性 ,于治疗 2周内 AL T仍异常。 结论 TTV感染是引起新生儿高胆红素血症的原因之一 ,部分可导致肝功能损害。更昔洛韦可能具有良好的抗 TTV感染的效果。
Objective To investigate the relationship between neonatal hyperbilirubinemia and transfusion transmitted virus (TTV) infection and the effect of ganciclovir on anti-TTV infection. Methods Twenty-two newborns with hyperbilirubinemia were divided into two groups: 125 cases had no etiology at present and 98 cases had found one or more etiology. Another 85 cases of normal newborns without hyperbilirubinemia as the normal control group. Using nested polymerase chain reaction, TTV DNA amplification, electrophoretic analysis and ALT were measured in peripheral blood of three groups of children. TTV DNA positive and ALT abnormalities in children, randomized to ganciclovir or ribavirin 10mg / (kg · d) for 7 days after treatment, the review of peripheral blood TTV DNA and ALT. Results In the group of unknown etiology, TTV DNA was detected in 12 cases of peripheral blood, the positive rate was 9.6%. In the group of definite etiology, TTV DNA was detected in 3 cases of peripheral blood, with a positive rate of 3.1%. TTV DNA in the normal control group was negative. Three groups of TTV infection rate differences have a very significant (P <0. 0 0 1). In 9 cases of TTV DNA positive and serum ALT abnormalities, 5 cases of ganciclovir treatment for 7 days, the peripheral blood TTV DNA were all negative, AL T within 2 weeks of treatment returned to normal; 4 cases of ribavirin treatment 2 TTV DNA in peripheral blood was still positive after week, and ALT remained abnormal within 2 weeks of treatment. Conclusion TTV infection is one of the causes of neonatal hyperbilirubinemia, which may lead to liver damage in part. Ganciclovir may have a good anti-TTV infection effect.