更昔洛韦治疗婴儿巨细胞病毒肝炎的不良反应观察

Adverse drug reactions of ganciclovir in treating infants with cytomegalovirus hepatitis

目的观察更昔洛韦治疗婴儿巨细胞病毒肝炎的不良反应及其影响因素。方法对某儿童医院2005年1月-2009年12月使用更昔洛韦治疗的婴儿巨细胞病毒肝炎患儿进行观察总结,记录不良反应的种类和发生率,并分析其影响因素。结果更昔洛韦治疗婴儿巨细胞病毒肝炎的不良反应发生率为29.46%(71/241,95%CI:23.70%～35.21%),其中骨髓抑制发生率为22.08%(51/231,95%CI:16.73%～27.43%),肝损害发生率为9.71%(20/206,95%CI:5.67%～13.75%)。71例发生不良反应并完成疗程的患儿,治疗有效46例(64.79%);170例未发生不良反应的患儿,治疗有效120例(70.59%),两组治疗有效率差异无显著性(x^2=0.79,P=0.38)。患儿性别,入院时是否有黄疸,是否早产、剖宫产,是否伴有感染等因素与不良反应的发生无相关性(均P>0.05)。结论更昔洛韦治疗婴儿巨细胞病毒肝炎有骨髓抑制和肝损害的不良反应,但不影响治疗效果。其不良反应无明显相关影响因素,在治疗过程中需加强监测。

Objective To observe the adverse drug reactions of ganciclovir in treating infants with cytomegalovirus （CMV） hepatitis, and to analyse the influencing factors. Methods Information of the infants who suffered from CMV hepatitis and administered with ganciclovir from January,2005 to December, 2009 was collected, and the incidence of adverse reactions was calculated. The SPSS statistical software was used to analyse the influencing factors. Results The total incidence of adverse reactions during the treatment of ganciclovir was 29. 46%（71/241,95%CI： 23. 70%- 35. 21%0）, the incidence of bone marrow suppression was 22. 08%（51/231,95%Ch 16. 73% - 27. 43%）, and the incidence of liver damage was 9. 71% （20/206, 95%CI： 5.67% - 13.75%）. Among 71 infants with adverse reaction , 46（64. 79 %）had effective treatment of ganciclovir; among 170 infants without adverse reaction, 120 （70. 59%） had effective treatment of ganciclovir, there was no significant difference in effective rate between two groups （X^2 = 0. 79, P = 0. 38）. There was no correlation between adverse reaction and infants＇ genders, jaundice, premature delivery, cesarean section,and infection （all P〉0. 05）. Conclusion Ganciciovir can induce the bone supression and liver damage, but the treatment effect is not affected, there is no correlated influencing factor with adverse reaction.