更昔洛韦治疗婴儿巨细胞病毒肝炎的临床体会

Clinical application of Ganciclovir in the treatment of infant cytomegalovirus hepatitis

目的:探讨婴儿巨细胞病毒(CMV)肝炎的临床特点,并观察更昔洛韦治疗的疗效及毒性反应。方法:对我院住院确诊为CMV肝炎的65例婴儿进行回顾性分析,在保肝、利胆、退黄等治疗的基础上,采用更昔洛韦抗病毒治疗。结果:全部患者治疗总有效率为83.08%,与治疗前相比,患者总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)、γ-谷氨酰转移酶(γ-GGT)明显下降,肝脾体积明显缩小,差异有统计学意义(P<0.05)。治疗后血清抗-CMV-IgM的总阴转率为75.38%。更昔洛韦对消化系统的影响、骨髓抑制作用及变态反应均较轻,经停药3～5 d及对症处理后恢复正常。结论:CMV肝炎临床主要表现为黄疸、肝脾肿大及肝功能异常,更昔洛韦治疗对婴儿CMV感染具有显著的临床疗效,且毒性反应轻,值得临床推广。

Objective： To explore the clinical features of infant cytomegalovirus（CMV） hepatitis and to observe the therapeutic efficacy and side effects of Ganciclovir.Methods： The clinical data of 65 cases of infant with CMV hepatitis in our hospital were analyzed retrospectively.These patients were given Ganciclovir anti-virus treatment in addition to liver protective,cholagogic and jaundice removing treatment.Results： The total effective rate was 83.08%.The TBIL,DBIL,ALT,γ-GGT,the size of liver and spleen dropped significantly after treatment（P0.05）.The negative conversion rate of anti-CMV-IgM in serum was 75.38% after treatment.Ganciclovir only showed slight effect on digestive system,slight bone marrow suppression effect and allergic effect.These effects disappeared 3-5 days after the withdrawal of the drug.Conclusion： The major clinical features of CMV hepatitis are jaundice,hepatosplenomegaly and liver dysfunction.Ganciclovir demonstrates significant effect on infant CMV infection and with slight toxic reaction,so it is worthy of clinical application.