更昔洛韦治疗新生儿先天性症状性巨细胞病毒感染  

Different dosages Ganciclovir treatment of symptomatic congenital cytomegalovirus infection in neonatal

作　　者：朱宏斌[1] 张凤仙[1] 郭彩萍[2] 

机构地区：[1]首都医科大学附属北京朝阳医院儿科,100020 [2]首都医科大学附属北京佑安医院感染科

出　　处：《中华实验和临床病毒学杂志》2012年第1期57-59,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的应用不同剂量更昔洛韦（GCV）治疗新生儿先天性症状性巨细胞病毒（CMV）感染，观察临床疗效和不良反应，评价其治疗效果和安全性。方法先天性症状性CMV感染新生儿37例随机分为高剂量治疗组（n=19）和低剂量治疗组（n=18），其中高剂量治疗组予GCV的剂量为：诱导治疗每次7．5mg／kg，维持治疗每次10mg／kg；低剂量治疗组予GCV的剂量：诱导治疗每次5mg／kg，维持治疗每次5mg／kg。观察两组的临床疗效和不良反应。结果不同剂量的GCV治疗先天性症状性CMV感染后临床症状均有所好转，高剂量治疗组CMV—IgM转阴率89．5％，CMV—DNA转阴率73．7％；低剂量治疗组CMV—IgM转阴率83．3％，CMV—DNA转阴率为77．8％，两组比较差异无统计学意义。低剂量GCV治疗先天性症状性CMV感染新生儿的不良反应低于高剂量GCV，低剂量治疗组中性粒细胞减少、贫血、血小板减少发生率低于高剂量治疗组，两组比较差异有统计学意义（P〈0．05）。结论低剂量GCV治疗新生儿先天性症状性CMV感染与高剂量有同样的临床疗效，且不良反应低于高剂量GCV。Objective Ganciclovir is a first line drug for treatment of cytomegalovirus （CMV） infection. This study aimed to compare the efficacy and side effects of relatively low and high doses of Gancidovir in the treatment of neonatal congenital CMV infection. Methods 37 neonates with congenital CMV infection were randomly assigned to high-dose （ n = 19 ） and low-dose Ganciclovir groups （ n = 18）. The high-dose Ganeiclovir group was injected with Ganciclovir of 7.5 mg/kg in the inducement phase and of 10 mg/kg in the maintaining phase. The low-dose Ganciclovir group was injected with Ganciclovir of 5 mg/kg in the inducement and the maintaining phases. The efficacy and side effects were observed in the two groups. Results The results of different doses of GCV treatment of congenital CMV infection in symptomatic by the clinical symptoms were improved,high-dose treatment group CMV-IgM negative rate of 89.5 % , CMV- DNA negative rate of 73.7% ; low-dose treatment group CMV-IgM switch negative rate of 83.3% , CMVDNA negative rate was 77.8% ,no significant difference between the two groups. Low-dose GCV treatment of congenital CMV infection in newborns with symptomatic side effects than high dose GCV,the low dose group neutropenia,anemia, thrombocytopenia was lower than the high dose group, the difference was significant （P 〈0.05）. Conclusion Lowdose GCV treatment of symptomatic congenital CMV infection with highdoses of the same clinical efficacy,and less side effects than high-doses of GCV.

关 键 词：婴儿 新生 巨细胞病毒 更昔洛韦 

分 类 号：R722[医药卫生—儿科]