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目的探讨输血传播病毒(TTV)感染与新生儿高胆红素血症的相关性及肝功能受损情况,并分析TTV(广州株)开放阅读框(ORF)1区基因序列特征。方法对58例高直接胆红素(5例肝病综合征)、92例高间接胆红素血症和85例正常新生儿,应用套式聚合酶链反应(PCR)技术进行外周血TTV DNA扩增、电泳及序列分析,同时检测血清丙氨酸转氨酶(ALT)。结果高直接胆红素患儿中,7例外周血检测出TTV DNA(阳性率为12．1%),其中3例肝病综合征患儿TTV DNA阳性；高间接胆红素血症和正常新生儿中,分别检出1例TTV DNA阳性(阳性率分别为1．1%和1．2%)。高直接胆红素(包括肝病综合征)患儿的TTV DNA阳性率明显高于高间接胆红素患儿和正常新生儿,差异有统计学意义(P＜0．01)。TTV广州株与日本株N22比较,同源性达87．1%～97．8%,但存在着点突变。结论TTV感染可能是本组引起新生儿直接胆红素升高的原因之一,TTV广州株与日本株具有同源性。
Objective To investigate the correlation between transfusion transmitted virus (TTV) infection and neonatal hyperbilirubinemia and the impaired hepatic function, and to analyze the gene sequence of open reading frame (ORF) region 1 of TTV (Guangzhou strain). Methods 58 cases of high direct bilirubin (5 cases of liver syndrome), 92 cases of high indirect bilirubin and 85 cases of normal newborn, using nested polymerase chain reaction (PCR) for peripheral blood TTV DNA amplification Increasing, electrophoresis and sequence analysis, simultaneous detection of serum alanine aminotransferase (ALT). Results Among the children with high direct bilirubin, TTV DNA was detected in 7 cases of peripheral blood (positive rate was 12.1%), of which 3 cases had TTV DNA positive in children with hepatosis syndrome; high indirect bilirubin and normal newborn Among them, one case of TTV DNA was detected positive (the positive rates were 1.1% and 1.2% respectively). The positive rate of TTV DNA in children with high direct bilirubin (including liver syndrome) was significantly higher than that in children with high indirect bilirubin and normal neonates (P <0.01). TTV Guangzhou strain compared with the Japanese strain N22, homology 87.1% ~ 97.8%, but there is a point mutation. Conclusion TTV infection may be one of the causes of direct bilirubin in neonates. TTV Guangzhou strain has homology with Japanese strain.