无明显器质性疾病成人巨细胞病毒病38例分析

基础医学与临床 ›› 2010, Vol. 30 ›› Issue (6): 662-665.

无明显器质性疾病成人巨细胞病毒病38例分析

孟长婷刘晓清周宝桐邱志峰邓国华

中国医学科学院北京协和医学院北京协和医院

收稿日期:2010-05-04 修回日期:2010-05-13 出版日期:2010-06-05 发布日期:2010-06-05
通讯作者: 周宝桐

Analysis of human cytomegalovirus diseases in 38 case of healthy adult

Chang-ting MENG, Xiao-qing LIU, Bao-tong ZHOU, Zhi-feng QIU, Guo-hua DENG

PUMC Hospital, CAMS & PUMC

Received:2010-05-04 Revised:2010-05-13 Online:2010-06-05 Published:2010-06-05
Contact: Bao-tong ZHOU,

摘要/Abstract

摘要： 目的总结分析无明显器质性疾病成年人巨细胞病毒感染的临床特点及实验室检查特点。方法回顾性收集1995年3月至2008年3月期间在北京协和医院住院的无明显器质性疾病成人CMV感染病例38例。分析其临床症状、体征、实验室检查、T细胞亚群、影像学特点、病理学特点,治疗及预后。结果无明显器质性疾病成人的巨细胞病毒感染临床表现多种多样，发热是最常见的症状，占68.4%,其他较常见表现包括淋巴结肿大（28.9%），肝大（34.2%），脾大（44.7%），外周血异型淋巴细胞比例增高（55.2%）等以及非特异性呼吸道，胃肠道症状；实验室检查血常规白细胞升高病例占20.8%,白细胞降低病例占37.5%；多数病例淋巴细胞百分比升高（65.0%），肝功能异常也较常见(66.7%)。急性期T淋巴细胞亚群的改变表现CD4和CD8+T淋巴细胞比例倒置，CD8+T淋巴细胞激活亚群(CD8+CD38+)数量明显增多（732±760 vs. 271114, P=0.024）以及NK细胞数量的减低（125±146 vs. 371±196, P=0.00）。经更昔洛韦为主的抗病毒治疗多数病人恢复，但1例多脏器功能衰竭死亡。结论无明显器质性疾病的成人感染巨细胞病毒临床表现多种多样，部分病情严重，临床工作中需要警惕CMV病。

关键词: 巨细胞病毒病, 健康成人, T淋巴细胞亚群

Abstract: Objective To analyze the features of human cytomegalovirus(CMV) infection in adults without obvious organic disease. Methods Restrospective analyze 38 cases of CMV infection in healthy adult inpatients without obvious organic disease from 1995 to 2008 in PUMC hospital,review their clinical manifestation, labortary test, treatment and prognosis. Results The features of CMV infection in adults without obvious organic disease are varied. Most common clinical feature is fever(68.4%), other include enlarged lymph nudes(28.9%), liver(34.2%) and spleen(44.7%) and atypical lymphocytes in peripherial blood. In acute phase of diseases, T cell subset showed reversed CD4/CD8 cell ratio, significantly increased amount of subset of CD8+ T cell(CD8+CD38+)（732±760 vs. 271114, P=0.024）. Decreased NK cell was also found（125±146 vs. 371±196, P=0.00）. Prognosis is poor in patients with mutiple organs dysfunction, Ganciclovir is effective. Conclusion: CMV diseases in healthy adult are with varied features and may cause severe diseases, which should be pay great attention.

Key words: cytomegalovirus disease, healthy adult, T cell subsets

孟长婷刘晓清周宝桐邱志峰邓国华. 无明显器质性疾病成人巨细胞病毒病38例分析[J]. 基础医学与临床, 2010, 30(6): 662-665.

Chang-ting MENG; Xiao-qing LIU; Bao-tong ZHOU; Zhi-feng QIU; Guo-hua DENG. Analysis of human cytomegalovirus diseases in 38 case of healthy adult[J]. Basic & Clinical Medicine, 2010, 30(6): 662-665.