阿昔洛韦治疗儿童肝移植受者EB病毒血症的安全性评价

Safety Evaluation of Acyclovir in the Treatment of Liver-transplanted Children with EB-viremia

目的:评价阿昔洛韦治疗儿童肝移植受者EB病毒(EBV)血症的安全性。方法:回顾性分析10例接受肝移植术后并发EBV血症患儿基本资料,术前供、受体EBV感染情况及治疗情况,干预前后他克莫司血药浓度,治疗前后血小板、血肌酐、白细胞水平,并随访复发情况。结果:所有患儿原发病均为胆道闭锁,EBV聚合酶链反应(EBV-PCR)呈阳性,供体均未常规检测EBV感染情况;有6例减少他克莫司的用药剂量,4例用药剂量维持不变,经干预后9例血药浓度降低;经治疗后9例转阴;治疗前后血小板、血肌酐、白细胞水平比较,差异均无统计学意义(P>0.05)。长期随访中发现2例复发。结论:阿昔洛韦用于治疗儿童肝移植受者EBV血症安全性较好。

OBJECTIVE： To evaluate the safety of acyclovir in the treatment of liver-transplanted children with EB-viremia. METHODS： Retrospectively analysis was conducted for the general information of 10 liver-transplanted children with EB-viremia, preoperative donor and recipient EBV infection and treatment, tacrolimus dose and plasma concentration before and after intervention, platelets, serum creatinine and white blood cell levels before and after treatment, and the recurrence were followed-up. RE- SULTS： Biliary atresia was the primary disease for all the children, EB virus polymerase chain reaction （EBV-PCR） was positive, and there was no routine testing for donor HBV infection; 6 cases reduced the tacrolimus dose, 4 remained unchanged, and 9 cases of plasma concentrations reduced after intervention, 9 were negative and 2 recoveried. There were no significant differences in the platelets, serum creatinine and white blood cells before and after treatment（P〉0.05）. CONCLUSIONS： Acyclovir can be used in the treatment of liver-transplanted children with EB-viremia, with good safety.