Smets Koenraad, De Coen Kris, Dhooge Ingeborg, Standaert Lieve, Laroche Sabrina, Mahieu Ludo, Logghe Noël, Cossey Veerle, Boudewyns An
Neonatal Intensive Care Unit, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Eur J Pediatr. 2006 Dec;165(12):885-90. doi: 10.1007/s00431-006-0192-2. Epub 2006 Jun 20.
The objective of this study is to look for evidence based or scientific guidelines for selection of newborns with congenital cytomegalovirus (CMV) infection that might benefit from treatment with ganciclovir.
A literature search was conducted involving the MEDLINE database and the Cochrane Collaboration Library. Abstracts were reviewed to select pertinent articles dealing with ganciclovir therapy in neonates. References from selected articles as well as from reviews were screened for additional relevant articles. In total, 13 case reports (16 patients in all), three descriptive uncontrolled studies (20 patients in all), two randomized dose-comparative studies (54 patients in all) and one randomized controlled study (42 patients) were identified.
All reported patients presented with central nervous system manifestation of CMV infection. Only the randomized controlled study showed a reduction of hearing deterioration in the treated group. Published predictors of hearing loss in congenitally CMV infected children allow identification of candidates that might benefit from treatment. Studies so far are promising but of insufficient number to make evidence based recommendations about indications for treatment of congenital CMV. As such, studies are very difficult to conduct and treatment of infants at high risk of hearing loss may appear justified. There is scientific data to help clinicians in selecting a subgroup of infants that is at higher risk of hearing deterioration and therefore might benefit the most from ganciclovir therapy.
本研究的目的是寻找基于证据或科学的指南，用于选择可能从更昔洛韦治疗中获益的先天性巨细胞病毒（CMV）感染新生儿。
进行了一项文献检索，涉及MEDLINE数据库和Cochrane协作图书馆。对摘要进行了审查，以选择有关新生儿更昔洛韦治疗的相关文章。对所选文章以及综述中的参考文献进行筛选，以查找其他相关文章。总共确定了13例病例报告（共16例患者）、三项描述性非对照研究（共20例患者）、两项随机剂量比较研究（共54例患者）和一项随机对照研究（42例患者）。
所有报告的患者均表现出CMV感染的中枢神经系统表现。只有随机对照研究显示治疗组听力恶化有所减少。已发表的先天性CMV感染儿童听力损失预测指标有助于识别可能从治疗中获益的候选者。迄今为止的研究很有前景，但数量不足以就先天性CMV治疗指征提出基于证据的建议。因此，研究非常难以开展，对听力损失高风险婴儿进行治疗似乎是合理的。有科学数据可帮助临床医生选择听力恶化风险较高、因此可能从更昔洛韦治疗中获益最大的婴儿亚组。
