更昔洛韦治疗婴儿巨细胞病毒肝炎35例临床分析

Clinical analysis of ganciclovir in treatment of infant cytomegalovirus hepatitis 35 cases

目的:探讨更昔洛韦治疗婴儿巨细胞病毒肝炎的临床疗效及其安全性。方法:将70例诊断为巨细胞病毒肝炎的患儿随机分为观察组和对照组各35例,对照组采取护肝、退黄、补充维生素等常规综合疗法,观察组在此基础上加用更昔洛韦治疗,比较两组疗效及其不良反应。结果:观察组总有效率为91.43%,对照组总有效率为40.00%,两组比较,差异有统计学意义(P<0.05);观察组治疗后总胆红素、直接胆红素、转氨酶分别为(45.6±32.2)μmol/L、(19.6±13.3)μmol/L、(28.5±12.5)U/L,较治疗前下降明显,差异有统计学意义(P<0.01),与对照组比较,差异有统计学意义(P<0.01);观察组治疗后肝脾也有明显回缩,与治疗前及对照组比较,差异有统计学意义(P<0.01)。观察组出现轻微胃肠道反应4例(11.43%),经对症处理后好转;治疗过程中无粒细胞及血小板减少现象,未发现肝肾功能异常。结论:更昔洛韦治疗婴儿巨细胞病毒肝炎能有效抑制病毒复制,退黄、护肝作用明显,副作用较小,值得临床推广。

Objective： To investigate the efficacy and safety of ganciclovir in the treatment of infant cytomegalovirus hepatitis. Methods： 70 patients diagnosed as cytomegalovirus hepatitis were randomly divided into observation group and control group 35 cases in each, the control group used liver protection, jaundice, vitamin supplements and other conventional combination therapy, the observation group added ganciclovir treatment, the efficacy and adverse reactions were compared. Results： The total effective rate of observation group was 91.43% and the control group was 40.00%, there was significant difference between the two groups （P0.05）; after treatment, the total bilirubin, direct bilirubin, aminotransferase observation group were （45.6±32.2） μmol/L, （19.6±13.3） μmol/L, （28.5±12.5） U/L, respectively, decreased significantly than before treatment, there were significantly differences （P0.01）, and compared with the control group, there also had statistical difference （P0.01）; observation group after treatment, there was a marked retraction of the liver and spleen, and compared with before treatment and control group, there was significant difference （P0.01）. The observation group had mild gastrointestinal reaction in 4 cases （11.43%）, improved after symptomatic treatment; there was no phenomenon of neutropenia and thrombocytopenia, abnormal liver and kidney function was not found. Conclusion： Ganciclovir treatment of cytomegalovirus hepatitis infant can effectively suppress viral replication, jaundice, liver obvious, fewer side effects and is worthy of promotion.