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先天性和后天获得性巨细胞病毒感染:长期随访

Congenital and postnatally acquired cytomegalovirus infections: long-term follow-up.

作者信息

Kumar M L, Nankervis G A, Jacobs I B, Ernhart C B, Glasson C E, McMillan P M, Gold E

出版信息

J Pediatr. 1984 May;104(5):674-9. doi: 10.1016/s0022-3476(84)80942-7.

Abstract

To determine long-term outcome of children with inapparent congenital cytomegalovirus infection, an assessment of congenitally infected children observed since birth was undertaken. Children with early postnatal acquisition of CMV infection were also evaluated. Cognitive, behavioral, neurologic, audiometric, and speech and language evaluations were performed in 48 patients, including 17 congenitally infected children, 10 children with postnatal infection, and 21 uninfected control subjects. Mean IQ of the three groups of children did not differ significantly. Behavioral, neurologic, speech and language examinations similarly failed to distinguish differences among the three groups. Audiologic abnormalities were present in four congenitally infected children, including one child with a severe unilateral sensorineural loss; in none of the children was hearing loss functionally significant. No hearing abnormalities were detected in postnatally infected children. Although inapparent CMV infection can result in audiologic sequelae, the continued lack of cognitive, behavioral, and neurologic sequelae in these school-age children reemphasizes the need to focus attention on prevention of primary maternal CMV infection to avoid the potentially devastating effects of intrauterine CMV infection.

摘要

为了确定先天性巨细胞病毒隐性感染儿童的长期预后,我们对自出生起就接受观察的先天性感染儿童进行了评估。同时也对出生后早期获得巨细胞病毒感染的儿童进行了评估。对48名患者进行了认知、行为、神经、听力以及言语和语言评估,其中包括17名先天性感染儿童、10名出生后感染儿童和21名未感染的对照受试者。三组儿童的平均智商没有显著差异。行为、神经、言语和语言检查同样未能区分三组之间的差异。4名先天性感染儿童存在听力异常,其中1名儿童有严重的单侧感音神经性听力损失;这些儿童中没有一例听力损失具有功能意义。出生后感染的儿童未检测到听力异常。虽然巨细胞病毒隐性感染可导致听力后遗症,但这些学龄儿童持续不存在认知、行为和神经后遗症,再次强调了需要将重点放在预防母亲原发性巨细胞病毒感染上,以避免宫内巨细胞病毒感染可能带来的毁灭性影响。

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