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[目的]探讨婴儿人巨细胞病毒(HCMV)肝炎的肝功能变化规律。[方法]选取2012年5月~2016年5月我院儿科收治的35例婴儿HCMV肝炎(HCMV肝炎组),45例婴儿嗜肝病毒肝炎(嗜肝病毒肝炎组)作为研究对象。检测所有研究对象的血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆汁酸(TBA)、白蛋白(ALB)、前白蛋白(PA)、拟胆碱酯酶(PCHE)以及血浆凝血酶原时间(PT)、国际标准化比值(INR)等指标。[结果]HCMV肝炎组患儿血清ALT为(89.5±53.1)U/L,显著低于嗜肝病毒肝炎组[(154.8±60.7)U/L,P<0.05],AST为(105.2±66.0)U/L,显著低于嗜肝病毒肝炎组[(214.5±97.9)U/L,P<0.05],GGT为(201.2±61.4)U/L,显著低于嗜肝病毒肝炎组[(362.8±73.7)U/L,P<0.05],TBIL为(54.5±11.3)μmol/L,显著低于嗜肝病毒肝炎组[(87.3±20.8)μmol/L,P<0.05],IBIL为(29.1±9.4)μmol/L,显著低于嗜肝病毒肝炎组[(46.0±13.7)μmol/L,P<0.05],TBA为(60.5±29.9)μmol/L,显著低于嗜肝病毒肝炎组[(93.6±38.5)μmol/L,P<0.05],ALB为(28.0±1.8)g/L,显著高于嗜肝病毒肝炎组[(25.1±1.5)g/L,P<0.05],PA为(139.2±56.9)mg/L,显著高于嗜肝病毒肝炎组[(95.3±34.5)mg/L,P<0.05],PCHE为(5025.0±543.7)U/L,显著高于嗜肝病毒肝炎组[(4162.5±369.4)U/L,P<0.05],血浆PT为(17.5±2.1)s,显著低于嗜肝病毒肝炎组[(23.4±2.8)s,P<0.05],INR为(1.64±0.28),显著低于嗜肝病毒肝炎组[(1.92±0.33),P<0.05]。[结论]与婴儿嗜肝病毒肝炎相比,婴儿HCMV肝炎的肝损伤程度更轻,因此上述指标可以用于婴儿HCMV肝炎与婴儿嗜肝病毒肝炎的鉴别诊断。
[Objective] To investigate the changes of liver function in infant human cytomegalovirus (HCMV) hepatitis. [Methods] Thirty-five infants with HCMV hepatitis (HCMV hepatitis group) and 45 infants with hepadnavirus (Hepatitis C virus group) were selected as pediatric subjects from May 2012 to May 2016 in our hospital. All subjects were tested for serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), total bilirubin (TBIL) (DBIL), indirect bilirubin (IBIL), total bile acid (TBA), albumin (ALB), prealbumin (PA), cholinesterase (PCHE) and plasma prothrombin time (PT) , International standardization ratio (INR) and other indicators. [Results] The serum ALT in HCMV hepatitis group was (89.5 ± 53.1) U / L, significantly lower than that in hepadnavirus group [(154.8 ± 60.7) U / L, P <0.05] (214.4 ± 97.9) U / L, P <0.05], and GGT was (201.2 ± 61.4) U / L, which was significantly lower than that in hepadnavirus group [(362.8 ± P <0.05], and IBIL was (29.1 ± 0.73), P <0.05], TBIL was (54.5 ± 11.3) μmol / L and significantly lower than that of Hepatitis B virus group [(87.3 ± 20.8) 9.4) μmol / L, which was significantly lower than that in hepadnavirus group [(46.0 ± 13.7) μmol / L, P <0.05] and TBA was (60.5 ± 29.9) μmol / 93.6 ± 38.5) μmol / L, P <0.05], and ALB was (28.0 ± 1.8) g / L, significantly higher than that of hepadnavirus group [(25.1 ± 1.5) g / (95.3 ± 34.5) mg / L, P <0.05], and PCHE was (5025.0 ± 543.7) U / L, which was significantly higher than that of hepadnavirus hepatitis group P <0.05). The INR was (1.64), (P <0.05) and [(4162.5 ± 369.4) U / L, P 0.05 and plasma PT 17.5 ± 2.1 s, significantly lower than that of the hepadnavirus group [(23.4 ± 2.8) ± 0.28), significantly lower than that of hepadnavirus group [(1.92 ± 0.33), P <0.05]. [Conclusion] Compared with infants with hepadnavirus hepatitis, HCMV hepatitis in infants has a lesser extent of hepatic injury. Therefore, the above indexes can be used in the differential diagnosis of infant HCMV hepatitis and infantile hepadnavirus.