先天性巨细胞病毒感染的母婴防治进展

徐雯芳; 袁天明

doi:10.7499/j.issn.1008-8830.2018.10.018

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中国当代儿科杂志 ›› 2018, Vol. 20 ›› Issue (10) : 870-875. DOI: 10.7499/j.issn.1008-8830.2018.10.018

综述

先天性巨细胞病毒感染的母婴防治进展

徐雯芳, 袁天明

作者信息 +

A review on the prevention and treatment of congenital cytomegalovirus infection in mothers and infants

XU Wen-Fang, YUAN Tian-Ming

Author information +

文章历史 +

摘要

人巨细胞病毒（HCMV）在世界范围内均有较高的感染率，先天性巨细胞病毒（CMV）感染者出生时85%~90%为无症状性感染，表现为听力损失、精神运动迟缓、学习障碍等；10%~15%为症状性感染，部分早产儿生后CMV感染，可造成败血症样综合征、血小板减少症、中性粒细胞减少症、肝损伤、肺损伤等。目前育龄妇女对CMV认识度极低，为孕妇提供CMV教育和卫生预防措施，可以预防怀孕妇女和新生儿先天性CMV感染。CMV疫苗及高价免疫球蛋白预防胎儿先天性CMV感染的研究尚无明确结果。近年来的研究证实尿液或唾液CMV-DNA检测的特异性和敏感性达98%以上，有助于先天性CMV感染的早期诊断。除了更昔洛韦的短期治疗，对有症状的先天性CMV感染患儿予口服缬更昔洛韦长期治疗更安全，而且似乎比短期治疗效果更好。未来还需加强对孕妇的宣传教育，加强对CMV感染的母婴管理，开展CMV疫苗的研究，以及进一步规范治疗方案等。

Abstract

Human cytomegalovirus (HCMV) has a high infection rate worldwide, and 85%-90% of congenital cytomegalovirus (CMV) infections are asymptomatic at birth, with the clinical manifestations of hearing loss, psychomotor retardation, and learning disabilities, while 10%-15% are symptomatic infections. Some preterm infants develop CMV infection after birth, which can cause sepsis-like syndrome, thrombocytopenia, neutropenia, liver injury, and lung injury. However at present, women of childbearing age have a lack of awareness of CMV. CMV education and hygiene precautions for pregnant women can prevent CMV infections in themselves and congenital CMV infections in their infants. No definite Results have been obtained from the studies on the effect of CMV vaccine and high-titer immunoglobulin in preventing congenital CMV infection in fetuses. Recent studies have confirmed that the specificity and sensitivity of urinary or salivary CMV-DNA detection have reached more than 98%, which contributes to the early diagnosis of congenital CMV infection. In addition to short-term treatment with ganciclovir, long-term treatment with oral valganciclovir is safe for symptomatic congenital CMV infection and appears to have a better clinical effect than the short-term treatment. In the future, it is necessary to strengthen the health education for pregnant women, enhance the mother-to-child management of CMV infection, conduct the research on CMV vaccine, and further standardize treatment regimens.

导出引用

徐雯芳, 袁天明. 先天性巨细胞病毒感染的母婴防治进展[J]. 中国当代儿科杂志. 2018, 20(10): 870-875 https://doi.org/10.7499/j.issn.1008-8830.2018.10.018

XU Wen-Fang, YUAN Tian-Ming. A review on the prevention and treatment of congenital cytomegalovirus infection in mothers and infants[J]. Chinese Journal of Contemporary Pediatrics. 2018, 20(10): 870-875 https://doi.org/10.7499/j.issn.1008-8830.2018.10.018

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