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目的 探讨巨细胞病毒(HCMV)载量对婴幼儿肝功能相关指标的影响及临床意义。方法 回顾性选取2022年11月至2025年4月于我院就诊的126例HCMV阳性婴幼儿为研究对象，采用实时荧光定量聚合酶链反应(qPCR)检测血清HCMV-DNA载量，根据载量水平分为低载量组(5.00×102拷贝/ml≤载量<1.00×105拷贝/ml,n=110)与高载量组(载量≥1.00×105拷贝/ml,n=16)。同时检测血清肝酶及肝功能指标，分析不同HCMV-DNA载量组间肝功能指标的差异、HCMV-DNA载量与肝功能指标的相关性，以及不同组间肝功能异常发生率的差异。结果 126例患儿HCMV-DNA载量范围为5.02×102拷贝/ml-1.20×106拷贝/ml，其中低载量组载量范围5.02×102拷贝/ml-9.80×104拷贝/ml；高载量组载量范围1.10×105-1.20×106拷贝/ml。高载量组患儿丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、直接胆红素(DBIL)水平高于低载量组(P<0.05)。Spearman相关性分析结果显示，HCMV-DNA载量与ALT、DBIL、GGT呈正相关，相关系数分别为0.452、0.418、0.547，其中与GGT相关性最强(P<0.05)。高载量组患儿ALT、GGT异常发生率均高于低载量组(P<0.05)；高载量组任意一项肝功能指标异常的总发生率为75.00%，显著高于低载量组的47.27%(P<0.05)。多因素Logistic回归分析结果显示：HCMVDNA高载量是肝功能异常的独立危险因素(OR=4.072,95%CI 1.215-13.654)。结论 HCMV-DNA载量与婴幼儿肝损伤密切相关，高载量可显著增加肝细胞损伤和胆汁淤积的发生风险，是肝功能异常的独立危险因素。同时，年龄较小和宫内感染也是婴幼儿HCMV感染后发生肝损伤的重要危险因素。
Abstract：Objective To explore the influence of cytomegalovirus(HCMV) load on liver function indicators of infants and young children and its clinical significance. Methods 126 HCMV-positive infants and young children who were treated in our Hospital from November 2022 to April 2025 were included in the study, with the serum HCMV DNA load detected through real-time fluorescence quantitative polymerase chain reaction(qPCR). According to the load level, the HCMV-positive infants and young children were divided into a lowload group(5.00×102 copies/ml ≤ load<1.00 × 105 copies/ml, n=110) and a high-load group(load ≥ 1.00 × 105 copies/ml, n=16). Simultaneously, serum liver enzymes and liver function indicators were detected. Analysis was performed on the differences in liver function indicators among the groups with different HCMV load, the correlation between HCMV-DNA load and liver function indicators, and the differences in the incidence of liver dysfunction among different groups. Results The HCMV-DNA load of 126 child patients ranged from 5.02×102 copies/ml to 1.20×106 copies/ml. Among them, the low-load group had a load range of 5.02×102 copies/ml to 9.80×104 copies/ml; the high-load group had a load range of 1.10×105 to 1.20×106 copies/ml. The levels of alanine aminotransferase(ALT), gamma glutamyl transpeptidase(GGT), and direct bilirubin(DBIL) in the high-load group were higher than those in the low-load group(P<0.05). The Spearman correlation analysis results showed that HCMV-DNA load was positively correlated with ALT, DBIL, and GGT, with correlation coefficients of 0.452, 0.418, and 0.547, respectively, and the HCMV-DNA load has the strongest correlation with GGT(P<0.05). The incidence of ALT and GGT abnormalities in the high-load group was higher than that in the low-load group(P<0.05). The total incidence of any liver dysfunction indicator in the high-load group was 75.00%, significantly higher than 47.27% in the low-load group(P < 0.05). The results of multivariate Logistic regression analysis showed that high HCMV-DNA load was an independent risk factor for liver dysfunction(OR = 4.072, 95% CI 1.215-13.654). Conclusion The HCMV-DNA load is closely related to liver injury in infants and young children. A high load can significantly increase the risk of hepatocyte damage and cholestasis, and thus it is an independent risk factor for liver dysfunction. Meanwhile, young age and intrauterine infection are also important risk factors for liver injury in infants and young children after HCMV infection.
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基本信息:
中图分类号:R725.1
引用信息:
[1]韩玉珍,王春玮,郭景景,等.巨细胞病毒载量对婴幼儿肝功能相关指标的影响及其临床意义[J].病毒学报().
基金信息:
青海省卫生健康委员会指导性计划课题(项目号:2022-wjzdx-93),题目:不同标本类型联合检测HCMV-DNA在青海地区新生儿人类巨细胞病毒感染中的应用研究
2026-09-01
2026-09-01
2026-09-01