河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (12): 1454-1458,1463.doi: 10.3969/j.issn.1007-3205.2022.12.017

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婴儿巨细胞病毒感染性肝炎病毒载量与γ-GGT的相关性及其对预后预测价值

  

  1. 1.江南大学附属医院儿科，江苏 无锡 214000；2.江苏省江阴市人民医院消化内科，江苏 无锡 214000

  • 出版日期:2022-12-25 发布日期:2023-01-11
  • 作者简介:陈思敏（1988-），女，江苏无锡人，江南大学附属医院主治医师，医学硕士研究生，从事儿科疾病诊治研究。
  • 基金资助:
    江苏省自然科学青年基金项目（BK20190652）

Correlation between viral load of infant cytomegalovirus infectious hepatitis and γ-GGT and its predictive value for prognosis

  1. 1.Department of Pediatrics, the Affiliated Hospital of Jiangnan University, Jiangsu Province, 
    Wuxi 214000, China; 2.Department of Gastroenterology, Jiangyin People′s Hospital, 
    Jiangsu Province, Wuxi 214000, China
  • Online:2022-12-25 Published:2023-01-11

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摘要： 目的 探讨婴儿巨细胞病毒（cytomegalovirus ，CMV）感染性肝炎病毒载量与γ-谷氨酰转移酶（γ-glutamyltransferase，γ-GGT）的相关性及其对预后预测价值。
方法 选取医院收治的163例CMV感染性肝炎患儿为研究对象，收集患儿基本资料，自患儿入院治疗后随访6个月统计其预后情况。分析CMV感染性肝炎患儿病毒载量与γ-GGT的相关性，分析影响CMV感染性肝炎患儿近期预后的因素，分析CMV病毒载量与γ-GGT预测CMV感染性肝炎患儿近期预后的价值。
结果 Pearson相关性分析显示CMV感染性肝炎患儿CMV-DNA病毒载量与γ-GGT水平呈正相关（P＜0.05）。163例CMV感染性肝炎患儿随访期间27例预后不良，136例预后良好。Logistic多因素回归分析显示CD4+/CD8+（OR：6.019，95%CI：2.477~14.629）、γ-GGT（OR：4.486，95%CI：1.846~10.903）、CMV-DNA载量（OR：5.859，95%CI：2.411~14.240）是影响CMV感染性肝炎患儿近期预后的危险因素（P＜0.05）。ROC曲线分析结果显示，CMV-DNA载量与γ-GGT预测CMV感染性肝炎患儿近期预后的敏感度分别为77.78%（95%CI：57.27~90.62）、74.07%（95%CI：53.41~88.13）、74.07%（95%CI：53.41~88.13），特异度分别为79.41%（95%CI：71.45~85.67）、77.21%（95%CI：69.07~83.77）、90.44%（95%CI：83.90~94.61），AUC分别为0.766（95%CI：0.671~0.862）、0.758（95%CI：0.656~0.861）、0.898（95%CI：0.835~0.962）。
结论 CMV感染性肝炎患儿病毒载量与γ-GGT水平有关，CMV病毒载量、γ-GGT可影响患儿预后情况，二者联合预测CMV感染性肝炎患儿预后效能良好。


关键词: 婴儿巨细胞病毒, 肝炎, γ-谷氨酰转移酶

Abstract: Objective To investigate the correlation between viral load of infantile cytomegalovirus(CMV) hepatitis(CMV) and γ-glutamyltransferase(γ-GGT) and its predictive value for prognosis. 
Methods A total of 163 children with CMV hepatitis admitted to the hospital were selected as the research subjects. The basic data of the children were collected, and the prognosis of the children was calculated at 6-month follow-up after admission. The correlation between viral load and γ-GGT in children with CMV hepatitis , and factors affecting the short-term prognosis of children with CMV hepatitis were analyzed. The value of viral load of CMV and γ-GGT in predicting the short-term prognosis of children with CMV hepatitis was analyzed. 
Results Pearson correlation analysis showed that CMV-DNA viral load was positively correlated with γ-GGT level in children with CMV hepatitis(P＜0.05). During the follow-up period of 163 children with CMV hepatitis, 27 had poor prognosis and 136 had good prognosis. Logistic multivariate regression analysis showed that CD4+/CD8+(OR:6.019, 95%CI:2.477-14.629), γ-GGT(OR:4.486, 95%CI:1.846-10.903), and CMV-DNA load(OR:5.859, 95%CI:2.411-14.240) were risk factors for the short-term prognosis of children with CMV hepatitis(P＜0.05). The results of ROC curve analysis showed that the sensitivity of CMV-DNA load and γ-GGT in predicting the short-term prognosis of children with CMV hepatitis was 77.78%(95%CI:57.27-90.62), 74.07%(95%CI:53.41-88.13), and 74.07%(95%CI:53.41-88.13), respectively; The specificity was 79.41%(95%CI:71.45-85.67), 77.21%(95%CI:69.07-83.77), and 90.44%(95%CI:83.90-94.61), respectively, and AUC was 0.766(95%CI:0.671-0.862), 0.758(95%CI:0.656-0.861), and 0.898(95%CI:0.835-0.962) respectively. 
Conclusion The viral load of children with CMV hepatitis is related to the level of γ-GGT, and CMV viral load and γ-GGT may affect the prognosis of children. The combination of the two has a good effect in predicting the prognosis of children with CMV hepatitis.


Key words: infantile cytomegalovirus, hepatitis, viral load, γ-glutamyltransferase, prognosis

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