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先天性巨细胞病毒感染的研究进展

  • 徐水宝 ,
  • 卢洪洲
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  • 复旦大学附属公共卫生临床中心,上海 201500

收稿日期: 2021-03-10

  网络出版日期: 2022-04-25

Research progress of congenital cytomegalovirus infection

  • XU Shuibao ,
  • LU Hongzhou
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  • Shanghai Public Health Clinical Center, Fudan University, Shanghai 201500, China

Received date: 2021-03-10

  Online published: 2022-04-25

摘要

巨细胞病毒(cytomegalovirus, CMV)在世界范围内均有较高的感染率,是最常见的先天性感染。先天性CMV感染可继发于母体原发性感染或非原发性感染。高达40%~50%的感染新生儿是在妊娠早期原发感染, 之后出现长期后遗症,主要包括先天性CMV感染相关听力损伤和神经后遗症。血清学检查对于确定原发性CMV感染至关重要。产前超声检查发现胎儿异常要警惕先天性CMV感染的可能性,磁共振成像有助于发现CMV相关脑异常。羊膜穿刺术是诊断胎儿CMV感染的金标准。加强育龄妇女及孕妇的卫生健康知识教育、减少CMV感染及抗病毒治疗是目前预防先天性CMV感染的主要措施。更昔洛韦及缬更昔洛韦是目前治疗CMV感染最有效的药物。高免疫球蛋白及CMV疫苗预防先天性 CMV 感染的作用尚无明确结论。

本文引用格式

徐水宝 , 卢洪洲 . 先天性巨细胞病毒感染的研究进展[J]. 微生物与感染, 2022 , 17(2) : 123 -128 . DOI: 10.3969/j.issn.1673-6184.2022.02.009

Abstract

Cytomegalovirus (CMV) is the most common congenital infection worldwide. Congenital CMV infection can be secondary to maternal primary infection or not primary infection. Up to 40% to 50% of infected newborns have long-term sequelae after primary infection in early pregnancy, mainly including congenital CMV infection related hearing loss and neurological sequelae. Serological examination is very important to determine primary CMV infection. Fetal abnormalities detected by prenatal ultrasound should be alert to the possibility of congenital cytomegalovirus infection. Magnetic resonance imaging is helpful to find CMV related brain abnormalities. Amniocentesis is the gold standard for the diagnosis of fetal CMV infection. Strengthening the health knowledge of women of childbearing age and pregnant women, reducing CMV infection and antiviral treatment are the main measures to prevent congenital CMV infection. Ganciclovir and valganciclovir are the most effective drugs in the treatment of CMV infection. There is no clear conclusion on the prevention of congenital CMV infection by hyperimmune globulin and CMV vaccine.
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