Phân tích PCR CMV trên dịch tai trong trong quá trình cấy ghép ốc tai: Một phương pháp chẩn đoán mất thính lực do CMV?

Zeitschrift für Kinderheilkunde - Tập 182 - Trang 375-383 - 2022
Emilien Chebib1, Christelle Vauloup-Fellous2,3, Charlotte Benoit1, Nathalie Noël Petroff1, Thierry Van Den Abbeele1, Audrey Maudoux1,4,5, Natacha Teissier1,3
1Department of Otolaryngology, Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP) and Université de Paris, Paris, France
2AP–HP Université Paris-Saclay, Hôpital Paul-Brousse, Department of Virology, INSERM U1193, Villejuif, France
3Groupe de recherche sur les infections pendant la grossesse (GRIG), Paris, France
4Center for Balance Evaluation in Children (EFEE), Department of Otolaryngology, Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris University, Paris, France
5Unit Progressive Sensory Disorders, Pathophysiology and Therapy, Institut de L’Audition, Institut Pasteur, Université de Paris, INSERM-UMRS1120, Paris, France

Tóm tắt

Đánh giá hiệu suất chẩn đoán của phản ứng chuỗi polymerase (PCR) virus cytomegalovirus (CMV) trên dịch tai trong thu thập được trong quá trình cấy ghép ốc tai và xác định tầm quan trọng của nó trong thực tiễn hiện tại. Nghiên cứu tiền cứu đơn trung tâm này bao gồm các trẻ em liên tiếp có mất thính lực cảm thụ âm nghiêm trọng đến sâu (SNHL) là ứng viên cho cấy ghép ốc tai đơn phương và/hoặc hai bên. Nguyên nhân của SNHL đã được xác định trước khi cấy ghép, khi có thể. Trong quá trình phẫu thuật, mẫu dịch tai trong và máu đã được thu thập. Sau đó, PCR CMV đã được thực hiện trên cả hai mẫu. Từ tháng 1 năm 2017 đến tháng 9 năm 2021, có 113 trẻ em mắc SNHL nghiêm trọng đến sâu đã trải qua cấy ghép ốc tai với việc thu thập dịch tai trong. Trong số các trẻ em này, 77 trẻ (68%) có nguyên nhân SNHL đã biết và 36 trẻ (32%) có nguyên nhân SNHL chưa xác định tại thời điểm phẫu thuật. Độ nhạy và độ đặc hiệu của PCR CMV trên dịch tai trong lần lượt là 60% (Khoảng tin cậy 95%: [49–71]) và 98% (Khoảng tin cậy 95%: [96–100]). Giá trị dự đoán dương tính và âm tính lần lượt là 90% (Khoảng tin cậy 95%: [83–97]) và 92% (Khoảng tin cậy 95%: [86–98]). Phân tích độ nhạy theo độ tuổi tại thời điểm cấy ghép cho thấy độ nhạy giảm theo độ tuổi. Kết luận: Việc lấy mẫu dịch tai trong trong quá trình phẫu thuật cấy ghép ốc tai là một phương pháp chẩn đoán mất thính lực liên quan đến CMV thú vị, đơn giản và an toàn, đặc biệt là khi chẩn đoán nhiễm trùng bẩm sinh không còn có thể được xác nhận. Tuy nhiên, độ nhạy giảm theo độ tuổi. Đăng ký thử nghiệm: NCT04724265

Từ khóa


Tài liệu tham khảo

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