膦甲酸钠治疗巨细胞病毒感染的临床观察

CLINICAL EFFECTS OF FOSCARNET IN THE TREATMENT OF CYTOMEGALOVIRUS INFECTION

目的 :研究国产膦甲酸钠 (PFA)治疗肾移植术后巨细胞病毒 (CMV)感染患者的疗效与不良反应。方法 :肾移植术后 5 5例CMV活动性感染 (16例有明显临床症状 )患者使用PFA ,随机另选 10例静止期感染患者不予处理作对照。PFA用量为 40mg/kg ,2 /日 ,2～ 3周为 1疗程。 结果 :无症状者PFA平均使用 13 4天后血清学抗CMV IgM转阴 ;有症状者治疗 14天后全部显效 ,临床症状消失 ,血清学抗CMV IgM转阴 ,另 2例治疗 1个月后血清学抗CMV IgM转阴 ,随访 1年无复发 ;对照组中有 2例分别于随访 2个月、3个月时转为CMV活动性感染。不良反应 :使用PFA者 2例出现一过性尿量减少、肾功能可逆性改变 ;2例出现皮肤潮红反应。 结论 :PFA可快速治疗CMV感染 ,疗效显著 ,是安全有效的治疗CMV感染的药物。

To observe the effects and side effects of foscarnet(PFA)in the treatment of cytomegalovirus(CMV) infection after renal transplantation. METHODOLOGY Active CMV infection(anti IgM +,IgG +)and inactive CMV infection(anti IgM ,IgG +)were determined with the use of ELISA.Fifty five cases of active CMV infection were selected to receive PFA treatment.And 10 cases with inactive CMV infection were followed up as control group without receiving PFA.PFA was administered intravenously at 40 mg/kg every 12 hours for 2 3 weeks in the active stage. RESULTS With the treatment of PFA,clinical symptoms of patients in active stage of CMV infection were controlled,and serologic CMV IgM turned negative.There were 2 cases in control group whose CMV IgM turned positive during follow up.Two patients receiving PFA had temporary urine volume decrement and reversible change in renal function.Another two patients had skin reaction. CONCLUSION PFA is effective in the control of active CMV infection.And it is a safe effective drug in the treatment of CMV infection in renal allograft recipients.