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目的调查我科收治的胆道闭锁(biliary atresia,BA)患儿巨细胞病毒(cy-tomegalovirus,CMV)感染率并探讨尿CMV快速培养在BA患儿诊治中的作用。方法对21例BA患儿血清CMV-IgM、CMV-IgG及尿CMV快速培养结果进行总结,同时采用Masson染色法检测患儿肝纤维化程度;根据尿CMV检测结果进行分组,比较两组患儿肝功能、肝纤维化程度及胆汁排出率的差别。结果BA患儿尿CMV快速培养阳性率为57.1%,高于血清CMV-IgM检测结果;尿CMV阳性组患儿肝功能及肝纤维化程度明显高于尿CMV阴性组,而术后胆汁排出率低于尿CMV阴性组。结论BA发生与CMV感染相关;尿CMV快速培养可用于诊断BA患儿CMV活动性感染;伴有CMV活动性感染的BA患儿肝损伤及肝纤维化程度均较严重,应尽早手术。
Objective To investigate the infection rate of cytomegalovirus (CMV) in children with biliary atresia (BA) admitted to our department and explore the role of urine CMV in the diagnosis and treatment of BA. Methods The results of rapid culture of serum CMV-IgM, CMV-IgG and urine CMV in 21 cases of children with BA were analyzed. Masson staining was used to detect the degree of liver fibrosis in children. According to the results of urine CMV test, Liver function, degree of liver fibrosis and biliary excretion rate difference. Results The positive rate of CMV rapid culture in BA children was 57.1%, which was higher than that of CMV-IgM. The liver function and liver fibrosis in urine CMV positive group were significantly higher than those in negative urine CMV group, while the postoperative biliary excretion rate Lower than urinary CMV negative group. Conclusions The occurrence of BA is associated with CMV infection. The rapid culture of urine CMV can be used to diagnose active CMV infection in children with BA. The incidence of liver injury and liver fibrosis in children with BA complicated with active CMV infection are serious and should be treated as soon as possible.