| 邢芳华,王荣坤,邢舒旺,邓武兴,陈 洁.更昔洛韦联合大剂量丙种球蛋白治疗婴儿巨细胞病毒性肝炎的疗效观察[J].,2018,(14):2763-2767 |
| 更昔洛韦联合大剂量丙种球蛋白治疗婴儿巨细胞病毒性肝炎的疗效观察 |
| Curative Effect of Gancicolovir Combined with High Dose Intravenous Immunoglobulin for Cytomegalovirus Hepatitis in Infants |
| 投稿时间：2017-09-01 修订日期：2017-09-24 |
| DOI：10.13241/j.cnki.pmb.2018.14.036 |
| 中文关键词: 婴儿 巨细胞病毒 肝炎 更昔洛韦 丙种球蛋白 疗效 |
| 英文关键词: Infant Cytomegalovirus Hepatitis Ganciclovir Intravenous immunoglobulin Curative effect |
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| 摘要 目的：研究更昔洛韦联合大剂量丙种球蛋白治疗婴儿巨细胞病毒性（CMV）肝炎的临床疗效，为婴儿CMV肝炎的抗菌治疗提供理论依据。方法：选取我院自2009年7月至2016年1月收治的103例CMV肝炎婴儿，根据随机数字表法分为治疗组58例，对照组45例。两组患儿均常规给予退黄、保肝药物治疗，对照组在此基础上给予更昔洛韦治疗，治疗组给予大剂量丙种球蛋白联合更昔洛韦治疗。对比观察两组患儿治疗后黄疸消退情况、肝功能变化、血CMV-IgM和尿CMV-DNA转阴情况、肝和脾B超变化、治疗效果及不良反应情况。结果：治疗组患儿黄疸消退时间、血CMV-IgM和尿CMV-DNA转阴时间均短于对照组（P＜0.05）；治疗组肝功能指标包括总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转肽酶（GGT）水平均较对照组和治疗前降低（P＜0.05）；治疗后两组肝、脾明显减小，且治疗组减小更显著，差异有统计学意义（P＜0.05）；治疗组中血CMV-IgM转阴率、尿CMV-DNA转阴率、治疗总有效率均高于对照组（P＜0.05）；治疗组不良反应发生率低于对照组（P＜0.05）。结论：更昔洛韦联合大剂量丙种球蛋白治疗婴儿CMV肝炎临床效果良好，可以有效缓解黄疸症状，恢复肝脏功能，肝、脾回缩明显，不良反应少，值得推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical curative effect of ganciclovir combined with high dose intravenous immunoglob- ulin in the treatment of cytomegalovirus (CMV) hepatitis in infants, and to provide a theoretical basis for antimicrobial treatment of cy- tomegalovirus hepatitis in infants. Methods: A total of 103 cytomegalovirus hepatitis infants, who were treated in, Sanya People's Hospi- tal of Hainan Province from July 2009 to January 2016,were selected and randomly divided into treatment group(n=58) and control group(n=45). The Infants of the two groups were given routine treatment of jaundice and liver protecting drugs, on the basis of which, the con- trol group was added ganciclovir, the treatment group were added high dose intravenous immunoglobulin combined with ganciclovir. The regression of jaundice, liver function, negative conversion of CMV-IgM and CMV-DNA, the size of liver and spleen, treatment ef- fect and adverse reaction of the two groups were compared. Results: The time of jaundice regression, the time of blood CMV-IgM and urine CMV-DNA negative results in the treatment group was shorter than that in the control group (P<0.05). The liver function indexes of the treatment group, total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) levels included, were lower than those of the control group and before treatment (P<0.05). After treatment, liver and spleen of the two groups were markedly reduced, and the treatment group was reduced more significantly, the difference was statistically significant(P<0.05). The blood CMV-IgM negative rate, urine CMV-DNA negative rate and total effective rate of treatment group were significantly higher than those of the control group (P<0.05). There was a statistical differences between the two groups (P<0.05). The incidence of ad- verse reaction in the treatment group was lower than that in the control group (P<0.05). Conclusion: The ganciclovir combined with high dose intravenous immunoglobulin in the treatment of cytomegalovirus hepatitis in infants has good clinical curative effect. It can effec- tively alleviate the symptoms of jaundice, restore liver function, retract the volume of liver and spleen obviously, with less adverse reac- tions, which is worthy to be promoted. |
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