CMV相关性肺炎临床特点及更昔洛韦的疗效分析

Clinical Characteristic of Cytomegalovirus Pneumonia and Therapeutic Effect of Ganciclovir

目的观察巨细胞病毒(cytomegalovirus,CMV)相关性肺炎的临床特点及更昔洛韦的临床疗效。方法将32例CMV肺炎患儿随机分为两组。治疗组17例,给予更昔洛韦治疗;对照组15例,给予其他抗病毒治疗,疗程均为2周。观察两组患儿临床疗效,治疗前后血常规,肝功能(ALT、AST),心肌酶(CK-MB、CTnI),免疫球蛋白,T淋巴细胞亚群的变化。结果治疗组发热时间、肺部啰音消失时间,住院天数较对照组明显缩短(P<0.01),咳嗽较对照组好转迅速(P<0.05)。治疗组在降低ALT、CK-MB、CTnI方面优于对照组(P<0.01或P<0.05)。与对照组相比,治疗组并不改变患儿白细胞计数(WBC)、中性粒细胞分类(N)、血小板(PLT),体液免疫IgG、IgA、IgM,细胞免疫CD4、CD8、CD4/CD8。与急性期相比,所有病例在恢复期WBC、N、ALT、AST、CK-MB、CTnI、IgG、CD4、CD8、CD4/CD8均有好转。结论 CMV相关性肺炎伴有全身多器官损害及免疫损伤。更昔洛韦治疗CMV肺炎有较好临床疗效。

Objective To observe the clinical characteristic of cytomegalovirus pneumonia and the treatment effect of ganciclovir.Methods Thirty-two children with cytomegalovirus pneumonia were randomly divided into treatment group （17 cases） treated with ganciclovir and control group （15 cases） treated with antiviral drugs except ganciclovir.The curative effect,blood routine,hepatic function （ALT,AST）,myocard creatase （CK-MB,cTnI）,immunoglobulin and T cell subsets were observed in the two groups before treatment and 2 weeks after treatment.Results Compared with the control group,fever time,extinction time of rales,and in-hospital days in treatment group were shorter （P0.01）.The improvement of cough was quicker （P0.05）.Treatment group was significantly better in decreasing the leves of ALT,CK-MB and CTnI （P0.01 or P0.05）.Compared with control group,there was no significant difference in white blood count （WBC）,neutrophil （N）,platelet （PLT）,IgG,IgA,IgM,CD4,CD8 and CD4/CD8. Compared with the acute stage,the levels of WBC,N,ALT,AST,CK-MB,CTnI,IgG,CD4,CD8 and CD4/CD8 were improved in convalescent period of all the cases.Conclusion Cytomegalovirus pneumonia accompanies with the damage of multiple organs and immunologic injury.Ganciclovir has a good therapeutic effect on cytomegalovirus pneumonia.