The Correlation Analysis Of HCMV Active Infection And Infantile Liver Dysfunction

ObjectiveTo investigate the relevant data of the children with liver functiondamage through retrospective analysis and to have a further research ofcorrelation analysis about CMV active infection and Liver function damagewithin3months of age.MethodsTo collect data of the children with liver function damage of29days to3months of age who detected liver function and CMV-IgM in Children’ sHospital of Chongqing Medical University in2013, and remove childrenwho were suspect biliary atresia and children with immune defects.Wedivided the chidren into the case group and the control group according towhether serum alanine aminotransferase(ALT) value was upper thereference limit(>50U/L).The case group divided into the biliary tractmalformations group and the hepatitis group according to whether the casehad biliary tract malformations. After being established a database ofrelevant data, all data were used by SPSS19.0statistical software forstatistical analysis,which were chi-square test,Logistic regression analysis,ttest et al. Results1.212cases included118cases of male,94cases of female. Hepatitisgroup included77cases, male: female=1.45:1; Biliary tract malformationgroup included79cases, male: female=1:1.39;The control group included56patients, male: female=1.33:1.There was no difference of proportion ofmen and women between children of29-day-old to2-month-old andchildren of2-month-old to3-month-old.2. The main clinical manifestations of156cases group patients(hepatitis group and group of patients with biliary tract malformation) werejaundice (88.3%to100%) and liver enlargement (54.6%to59.5%). The rateof over50%of DB/TB in hepatitis group was73.5%. The rate of over50%of DB/TB in group of patients with biliary tract malformation was89.9%.Children with jaundice mostly had cholestasis.Hepatomegaly was mild tomoderate (the liver under the rib over2cm，54.6%to59.5%), the rate of sizeof the liver under the rib less than5cm was low.Most of the group of patientswith biliary tract malformation had liver texture change such as partial hard4/47cases (8.5%),one of them also had splenomegaly.3. The rates of the positive result of the serum CMV-IgM among thehepatitis group, the group of patients with biliary tract malformation and thecontrol group were46.8%,35.4%,12.5%.There was significantly differencebetween the hepatitis group and the control group for the rate of positiveresult of the serum CMV-IgM.The same result between the group of patients with biliary tract malformation and the control group for the rate of positiveresult of the serum CMV-IgM.4. Logistic regression analysis of the hepatitis group and the controlgroup showed that P <0.05, the OR is6.146, the OR95%CI is (2.475,2.475). Logistic regression analysis of the group of patients with biliarytract malformation showed that P=0.004＜0.05, the OR is3.843, the OR95%CI is (1.537,1.537).5. In the hepatitis group,the ALT average concentration of was193.88±161.404,mild increase in ALT levels was76.6%,mild to moderateincrease in ALT levels was94.8%.There was no significant difference inALT average levels between the categories of antibody positive and ofantibody negative among the hepatitis group.In the biliary tractmalformation group, the ALT average concentration of was184.70±115.544,mild increase in ALT levels was81.0%, mild to moderate increase in ALTlevels was98.7%.There was no significant difference in ALT average levelsbetween the categories of antibody positive and of antibody negative amongthe biliary tract malformation group.Classified according to the ALT levelsfor <2times,2-5times,5to10times,>10times the reference limit, therewere28cases,31cases,14cases,4cases among the hepatitis group;therewere,16cases,48cases,14cases,1case.There were no significantdifference of ALT levels grading between the categories of antibody positiveand of antibody negative among two groups. 6. In the hepatitis group,38/77cases (49.4%) diagnosed CMV hepatitis,4cases suspected CMV hepatitis,6cases had CMV infection which is notmake sure that CMV infection is the main cause of liver damage. Diagnosisof other children were not clear.In the biliary tract malformation group,64/79cases (81.0%) diagnosed biliary atresia,10/79(12.7%) diagnosed biliarystenosisi,3/79cases diagnosed choledochocyst,2/79cases diagnosedcholedochectasia,16/79cases had CMV hepatitis (20.2%).Conclusion1. In the children with liver function damage of29days to3months ofage of the Children’ s Hospital of Chongqing Medical University in2013,49.4%cases diagnosed CMV hepatitis in the group without biliary tractmalformation,the rate of CMV-IgM antibody positive was46.8%, and theproportion of explosion of risk factors of CMV infection of children withoutbiliary tract malformation was6.146times that of the normal children.CMVactive infection was considered that it may be the leading causes of infanthepatitis patients, both may have a certain correlation.2. In the children with liver function damage of29days to3months ofage of the Children’ s Hospital of Chongqing Medical University in2013,only20.3%cases had CMV hepatitis in the group with biliary tractmalformation,but the rate of CMV-IgM antibody positive was35.4%, andthe proportion of explosion of risk factors of CMV infection of children withbiliary tract malformation was3.843times that of the normal children.We could considere that the children with biliary tract malformation had a highrate of CMV active infection,but there was no strong evidence that provedCMV active infection might be leading cause of bile tract malformation.3. No matter whether the children had biliary tract malformation, mostof the children with liver function damage had jaundice (88.3%to100%),liver enlargement (54.6%to59.5%) which were the mainperformance, and a majority of children with jaundice had cholestasis. Amajority of hepatomegaly was mild to moderate,the rate of size of the liverunder the rib less than5cm was low.Many patients with biliary tractmalformation had liver texture change, serious had a hard texture.4. No matter whether the children had biliary tract malformation, mostof liver function damage showed aminotransferase elevated mild tomoderate.There was no certain correlation between CMV active infectionand the liver function damage severity.