更昔洛韦(丽科伟)在先天性巨细胞病毒感染的临床应用

The clinical application of ganciclovir in congenital cytomegalovirus,infections

目的 评价更昔洛韦治疗先天性巨细胞病毒 ( CMV)感染的疗效及其影响因素。 方法 将 30例确诊为先天性CMV感染的患儿分为症状性 16例和无症状性 14例两组 ,按照更昔洛韦诱导和维持治疗相结合的方案 ,根据定量 CMV-PCR结果判断其疗效。 结果 更昔洛韦诱导治疗结束后转阴率为 17/30 ( 5 6 .8% ) ,维持治疗结束后转阴率为 2 6 /30 ( 86 .7% ) ;CMV-DNA≤ 10 4/m l的患儿诱导治疗结束后的转阴率高于 >10 4/ml的患儿 ( P<0 .0 5 ) ,而且无症状性感染诱导治疗结束后的转阴率高于症状性感染 ( P=0 .0 0 7) ;维护治疗结束后两两比较均无差异。 结论 更昔洛韦治疗先天性 CMV感染安全有效 ,其疗程与CMV-DNA拷贝数大小及感染类型有关 ,建议对所有先天性

Objective To investigate the therapeutic effect of ganciclovir on congenital cytomegalovirus (CMV) infections and relative factors.Methods 30 cases of congenital CMV infections were divided into symptomatic (n=14) and asymptomatic (n=16 groups.Both groups were treated with ganciclovir according to the routine regime.The results of quantitive CMV-PCR were applied to evaluate the therapeutic effect.Results After treatment,the negative rate was 17/30 (56^8%) in Induction phase and 26/30 (86^7%) in Maintenance phase.The negative rate in Induction phase of infants with CMV-DNA ≤10+4 copy/ml was higher than those with CMV-DNA>10+4 copy/ml (P<0^05).The negative rate in Induction phase of asymptomatic infants was also higher than symptomatic ones (P=0^007) The rate in Maintenance phase were insignificantly different.Conclusion It was safe and effective to treat congenital CMV infections with ganciclovir and its course was relevant to the number of CMV-DNA and the type of infection.It is suggested that all of infants with congenital CMV infections should be early given intervening therapy.