巨细胞病毒肝炎患儿细胞免疫功能变化和干扰素的临床疗效  

Study of cell-medjated immunity of infantile human cytomegalovirus hepatitis and effets of interferon for the disease

作　　者：唐瑟[1] 熊英[1] 陈永秀[1] 姚裕家[1] 

机构地区：[1]华西医科大学附属第二医院儿科

出　　处：《实用儿科临床杂志》1996年第2期69-69,共1页Journal of Applied Clinical Pediatrics

摘　　要：目的研究巨细胞病毒（ＨＣＭＶ）肝炎患儿细胞免疫功能是否受损；经治疗后临床症状恢复期中免疫功能的恢复情况；干扰素对巨细胞病毒肝炎的疗效。方法用ＤＮＡ探针斑点原位杂交，酶兔方法检查ＨＣＭＶ抗原，尿中分离ＨＣＭＶ３种方法诊断ＨＣＭＶ肝炎。用ＩＬ－２活性测定、Ｔ细胞亚群测定检测患儿细胞免疫功能，将患儿分为干扰素加维生素Ｃ、肌苷治疗组（γＩＦＮ）和仅用维生素Ｃ、肌苷治疗组（非γＩＦＮ），连续观察３个月临床症状恢复情况。结果ＨＣＭＶ肝炎患儿有明显的细胞免疫功能损伤，且临床症状缓解后部份免疫功能尚不能完全恢复。干扰素治疗组的临床症状恢复和第１月与第２月的痊愈率明显优于无干扰素治疗组。黄疸消退平均提前１４．９天（Ｐ＜０．０５）；肝肿大恢复正常提前２８．４天（Ｐ＜０．０１），ＳＧＰＴ恢复正常平均提前１４．９天（Ｐ＜０．０１）。两组的第１月与第２月痊愈率分别为４８．６％与２０．６％、８８．６％与４７．１％（Ｐ＜０．０５）。结论ＨＣＭＶ患儿细胞免疫功能均受损，且不能随症状好转而立即全部好转。干扰素能使ＨＣＭＶ患儿的临床症状加快消退。Objectives To research function of cell-mediated immunily and effects of interferon in treating infantile human cytomegalovirus (HCMV) hepatitis.Methods Three methods, included a specific probe to hybridize with DNA of human cytomegalovirus (HCMV), separating the HCMV from urine and culturing them, serum ELISA-CMV-IgM, were used in diagnosis of 87 infants with hepatitis syndrome. The 69 cases with HCMV hepatitis were confirmed.Interleukin (IL-2), CD3, CD4, CD8 and CD4/CD8 ratio of peripheral blood leukocytes of 22 cases among the 69 cases were investigated in different clinical stages. The 35 cases were treated with interferon together with daily vitamin C and inosine therapy intravenously, other 34 cases were only treated with daily vitamin C and inosine therapy for control.Results The cell-mediated immunity was imparted in in infants with HCMV hepatitis. Athough the patient have clinical improvements accompanied with clevation values of IL-2 and CD3, CD4 and CD8were sitll abnormal during convalescence. There as a significant difference in clinical symptoms disappearance between the two groups. The average alleviating time of jaundice, hepatomegaly and serum SGPT level after treatment with γIFN were 14.9, 28.2 and 14.9 days ahead of those in the control group. The cure rate at one month and two months after treatment was 48.6% and 88.6% in th γIFNgroup; 20.6 % and 47.1% in the control group.Conclusions The function of cell-mediated immunity was wrecked in infantile human cytomegolovirues hepatitis. The γ-IFN was effective in treatment of HCMV hepatitis.

关 键 词：细胞免疫 巨细胞病 肝炎 干扰素 婴儿 

分 类 号：R725.126[医药卫生—儿科]