更昔洛韦治疗小儿传染性单核细胞增多症的疗效及其对EB病毒特异性抗体的影响

Analysis of the therapeutic effect of ganciclovir and its influence on specific antibody to EB virus in the treatment of children with infectious mononucleosis

目的 探讨更昔洛韦（ganciclovir,GCV）治疗小儿传染性单核细胞增多症（infectious mononucleosis,IM）的临床疗效并分析其对EB病毒（epstein-barr virus）特异性抗体（VCA-IgM）的影响.方法 选取2011年1月至2014年1月成都青白江区人民医院儿科收治的IM患儿60例,随机将其分至观察组和对照组.观察组给予GCV治疗,对照组给予干扰素（IFN-α）治疗.比较两组患儿临床症状改善情况、治疗有效率、治疗后VCA-IgM抗体转阴以及不良反应等情况.结果 观察组退热时间以及咽峡炎症状好转时间明显短于对照组[（3.57±1.24）d vs （4.76±1.35）d]、[（4.73±1.36）d vs （6.22±1.75）d]（P＜0.05）,治疗显效率明显大于对照组（50.0％ vs 26.7％,P＜0.05）,治疗后3个月的VCA-IgM抗体阳性率明显小于对照组（13.3％ vs 53.3％,P＜0.05）,无明显不良反应发生.结论 GCV在小儿IM的治疗中疗效显著,可促使EBv特异性抗体转阴.

Objective To investigate the clinical efficacy of ganciclovir （GCV） in the treatment of children with infectious mononucleosis （IM） and to detect the GCV＇ s influence on EB virus specific antibodies （VCA-IgM） . Methods Sixty children with IM was collected from Qingbaijiang people＇ s hospital from January 2011 to January 2014. The patients were divided into treatment group and control group randomly. Patients in treatment group were given GCV, patients in control group were given IFN- a as treatment. The clinical symptoms improved, treatment efficiency, VCA-IgM and side effect were tested and compared between these two groups. Results The mean antipyretic time and mean term of sore throat relief was 3.57 d ± 1.24 d and 4. 76 d ± 1.35 d respectively in treatment group, which were significantly shorter than the time in control 4. 73d ± 1.36 d and 6. 22d ± 1.75d , respectively. The effective rate of treatment group was significantly higher than that of control group 50. 0% vs 26. 7%. Three months after treatment, the positive rate of EBv-VCA-IgM in treatment group was significantly lower than that in control group 13.3% vs 53.3%. No severe side effect was observed in treatment group. Conclusions GCV is effective in treating children with IM. GCA can decrease EBv-VCA-IgM effectively.