更昔洛韦治疗儿童巨细胞病毒感染的三组方案比较

THREE METHODS OF GANCICLOVIR FOR CHILDREN WITH CYTOMEGALOVIRUS INFECTION

目的采用三种方案评价更昔洛韦对儿童巨细胞病毒感染的疗效。方法将256例巨细胞病毒感染患儿随机分成三组:A组(n=72)更昔洛韦5mg/kg,1次/d,间歇用药;B组(n=56)诱导期更昔洛韦5mg/(kg.次),2次/d,给药14d后,给予5mg/(kg.d),维持3个月;C组(n=128),诱导期更昔洛韦7.5mg/(kg.次),2次/d,给药14d后改10mg/(kg.d),每周3次,共维持3个月。结果A组诱导期转阴率为31.9%,3个月转阴率为54.2%;B组诱导期转阴率为58.9%,3个月转阴率为83.9%;C组诱导期转阴率为76.6%,3个月转阴率为92.2%,(P<0.05)。治疗过程中三组患者均有出现轻度肝功能受损者及WBC、PLT减少,无显著差别。结论更昔洛韦是治疗巨细胞病毒感染的特效药,对于儿童巨细胞病毒感染效果显著,安全性好。采用大剂量多疗程治疗较小剂量单疗程治疗效果较好。

Objective To evaluate therapeutic effects of ganciclovir on children cytomegalovirus（CMV） infection in three therapeutic projects. Methods 7.56 children cases with CMV infection were divided into three groups randomly, the three groups were treated with different dosage of ganciclovir. Group A（n = 72）were treated with ganciclovir 5mg/kg every day, and the treatment was fitful; Group B（n = 56）were treated with ganciclovir 5mg/kg at a time, intravenous drip every 12 hours, continuously using for 14 days. Then maintenance treatment with 5mg/kg intravenous drip every day for 3 months, Group C（n = 128） were treated with higher dosage of ganciclovir; induced 7.5mg/kg at a time, intravenous drip every 12 hours, continuously using for 14 days. Then maintenance treatment with 10mg/kg intravenous drip everyday, for 3 - day every week. maintenance treatment for 3 months. Results Group A, in derivational days the rates of turn feminine were 31.9 % and 54.2 % after 3 months; Group B, in derivational days the rate of turn feminine was 58.9 % and after 3 months the rate was 83.9 %; Group C, in derivational days the rates of turn feminine were 76.6 % and 92.2 % after 3 months. Conclusion Using higher dosage, full course ganciclovir treating children CMV infection b.ave remarkably efficacy and safe in the disease at the onset, so can be widespread in clinical practice.