| Objective:In this study,we retrospectively analyzed the clinical features of 483 cases of human cytomegalovirus(HCMV)disease,and analyzed 459 cases of ganciclovir(GCV)anti-HCMV treatment,and finally reached safer and effective diagnosis treatment of children with cytomegalovirus disease.Methods:Through the electronic medical record information management system of Jiangxi Children’s Hospital,3954 children diagnosed with cytomegalovirus infection from February 2012 to August 2018 were retrieved.According to the inclusion and exclusion criteria of this study,483 children with HCMV disease were eventually included in the study.The clinical data,laboratory results and imaging findings of483 children were retrospectively analyzed.The clinical characteristics,laboratory and imaging findings,and adverse reactions of 459 patients enrolled in GCV were analyzed.SPSS22.0 statistical software was used to analyze the data,use the number of cases(percentage)[n(%)]to represent enumeration data,the normal distribution of measurement data is expressed as x±s deviation and compare two groups by t test,the non-normal distribution of measurement data is expressed as median(M),the degree of correlation between the two categorical variables is the Pearson column connection number,P<0.05 was defined as a statistically significant difference.Results:1.Among the 483 children enrolled,331(68.5%)were male and 152(31.5%)were female;68(14.1%)in<14-day group,206(42.7%)in the14-day~3-month group,and the 3-month~6-month group 146 cases(30.2%),63 cases(13.0%)in the>6-month group;445 cases(92.1%)in term,38 cases(7.9%)in preterm delivery;371 cases(76.8%)in delivery,112 cases(23.2%)in caesarean section 164 cases(34.0%)were breastfed,250 cases(51.8%)were fed artificially,and 69 cases(14.2%)were mixed feeding.The incidence of HCMV disease in children was the highest in autumn and winter,162 cases(33.5%)and 178 cases respectively.(36.9%);287 cases(59.4%)of blood system damage,317 cases(65.6%)of liver damage,53 cases(11.0%)of hearing damage,41 cases(8.5%)of lung damage,and digestion There were 2 cases(0.4%)with symptomatic symptoms and 238 cases(49.3%)with multiple organ dysfunction.Among them,liver damage was the most common,followed by blood system damage.In the<14-day group,52 cases(76.5%)were liver damage,29 cases(42.6%)were hematological damage,and 27 cases were hearing loss(39.7%).The 14-day~3-month group showed 145 cases(70.4%)with liver damage,97 cases(47.1%)with hematological damage,and 25 cases(12.1%)with pneumonia.The main symptoms of the system were blood system damage from the 3-month~6-month group.107 cases(73.3%),liver damage in 93 cases(63.7%),malnutrition in 13 cases(8.9%),the>6-month group mainly showed blood system damage in 54 cases(85.7%),liver damage in 27 cases(42.9%)5 cases of congenital malformation(7.9%).2.Serum HCMV-DNA load and 53 children with hearing damage in the left ear(r=0.980,P=0.000),right ear(r=0.932,P=0.007),binaural(r=0.599,P=0.031)auditory Brainstem response(ABR)hearing threshold was correlated(P<0.05);Serum HCMV-DNA load and DBIL(r=0.343,P=0.000),GGT(r=0.566,P=0.000),ALB(r=-0.440,P=0.000),IgM(r=0.488,P=0.000)was correlated(P<0.05),and there was no correlation with WBC,EO#,N#,PLT,RBC,ALT,AST,TBIL,BUN,SCr,IgA,IgG,C3,C4(P>0.05).3.The effective rates of serum HCMV-DNA load,hepatomegaly,fever,skin hemorrhage,dystonia,and jaundice were 90.8%,100%,89.8%,96.2%,87.9%,and90.1%,respectively.Before and after GCV treatment,the comparison of laboratory indexes WBC(t=6.235,P=0.000),PLT(t=-4.169,P=0.000),ALT(t=4.090,P=0.000),AST(t=4.775,P=0.000)and liver~#(t=20.263,P=0.000)was statistically significant(P<0.05).Adverse reactions after treatment were analyzed:bone marrow suppression in 47 cases(10.2%)was mainly manifested as anemia/anemia aggravation in 39 cases(83.0%),liver function damage in 61 cases(13.3%)was mainly manifested as elevation of AST in 33 cases(54.1%),and allergic reaction in14 cases(3.1%).Conclusion:1.Children with HCMV disease often manifest as non-specific organ damage symptoms,with the increase of age the incidence of respiratory,digestive,nervous system damage gradually decreased,and the overall trend of the incidence of blood system damage is growing.2.Serum HCMV-DNA load is correlated with hearing threshold in children with hearing damage.3.Serum HCMV-DNA load is correlated with DBIL,GGT,and ALB.4.GCV can effectively improve the clinical symptoms of children with HCMV disease.It can cause bone marrow suppression,liver function damage and allergic reactions during treatment. |
