更昔洛韦治疗婴儿巨细胞病毒性肝炎(淤胆型)的疗效及不良反应观察  

Observations on the effectiveness and adverse drug reactions of ganciclovir treatment for cholestasis type of infant cytomegalovirus hepatitis

作　　者：熊小丽[1] 陈鹏[2] 鄢素琪[1] 汤建桥[1] 谢东[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心中西医结合科,湖北武汉430016 [2]武汉市妇女儿童医疗保健中心呼吸内科,湖北武汉430016

出　　处：《中国医院药学杂志》2013年第7期563-566,共4页Chinese Journal of Hospital Pharmacy

基　　金：武汉市科技局2011年青年科技晨光计划项目[编号:武科技(2011)40号]

摘　　要：目的:观察更昔洛韦(ganciclovir,GCV)治疗婴儿巨细胞病毒性肝炎(淤胆型)的有效性及近期不良反应。方法:将确诊为婴儿巨细胞病毒性肝炎(淤胆型)患儿100例为观察病例,观察总有效率,监测更昔洛韦治疗过程中中性粒细胞计数、血小板计数、血红蛋白含量、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、血尿素氮(blood urea nitrogen,BUN)、肌酸激酶同工酶(creatine kinase MB,CK-MB)、活化的部分凝血活酶时间(activated partial thrombopalstin timen,APTT)的变化情况及震颤、烦吵、呕吐等症状。结果:显效80例,有效15例,无效5例,其总有效率为95%,总不良反应发生率为35%(35/100)。其不良反应发生主要集中在诱导期治疗中,不良反应中主要表现为血液系统影响和肝功能损害、震颤,所占比例分别为14%、9%、6%。血液系统中,以血红蛋白降低最为明显。结论:GCV治疗婴儿巨细胞病毒性肝炎(淤胆型)有较好的临床疗效,但在治疗过程中存在近期不良反应,这些不良反应在停药对症处理后均可缓解,故在治疗前需要权衡利弊。OBJECTIVE To observe the effectiveness and the recent adverse drug reactions of ganeiclovir treatment for cholestasis type of infant cytomegalovirus hepatitis. METHODS 100 cases diagnosed as cholestasis type of infant cytomegalovirus hepatitis were enrolled to observe the total effective rate and to monitor the change of neutrophil count, platelet count, hemoglobin, ALT, BUN, CK-MB and the symptoms of tremor, vexed noise and vomitting. RESULTS 80 cases had marked effects and 15 cases were effective, 5 case without effect. Total effective rate was 95. 00%. Total adverse drug reaction （ADR） rate was 35 %. The ADR mainly occurred in induced phase treatment, mainly showed as the effects on haematopoietic system, liver damage and tremor, the rate of which was 14%, 9% and 6% respectively; hemoglobin reduction was the most obvious effect in haematopoietic system. CONCLUSION Recent ADR occurred in ganciclovir treatment for eholestasis type of infant cytomegalovirus hepatitis, the ADR will remit after drug withdrawal and symptomatic treatment, the doctors should weigh the benefitrisk balance.

关 键 词：更昔洛韦 不良反应 巨细胞病毒 婴儿 巨细胞病毒性肝炎(淤胆型) 

分 类 号：R978.7[医药卫生—药品]