脾氨肽联合更昔洛韦治疗对小儿巨细胞病毒感染的T淋巴细胞亚群及CMV-DNA载量影响  

Effect of the combination treatment of spleen ammonia peptide and ganciclovir on T lymphocyte subsets and CMV-DNA loading in children with cytomegalovirus infection

作　　者：王金范 WANG Jin-fan(Zhuji Maternal and Child Health Care Center ,Zhuju 311800, Chin)

机构地区：[1]诸暨市妇幼保健院,诸暨311800

出　　处：《现代免疫学》2018年第2期124-128,共5页Current Immunology

基　　金：浙江省卫生局课题(20148001)

摘　　要：研究脾氨肽联合更昔洛韦治疗对巨细胞病毒感染患儿血清T淋巴细胞亚群及尿液CMV-DNA载量的影响。样本为巨细胞病毒感染患儿98例,按照随机数字法将其均分为观察组和对照组,每组49例。所有患儿入院后均接受对症支持治疗,并给予更昔洛韦静脉滴注抗感染治疗,在此基础上,观察组患儿给予口服脾氨肽联合治疗,疗程均为4周。结果显示,观察组患儿的治疗总有效率为89.80%,对照组患儿的治疗总有效率为73.47%(χ2=4.36,P=0.04);两组患儿血清CD4+T细胞和CD4+/CD8+T细胞明显高于治疗前,且观察组高于对照组,CD8+T细胞水平明显低于治疗前,且观察组低于对照组,比较差异均有统计学意义(P<0.01);两组患儿治疗前尿液CMV-DNA载量比较无显著性差异(P>0.05),经过治疗后均明显低于治疗前,且观察组低于对照组,比较均有统计学意义(P<0.01);观察组患儿不良反应发生率(14.29%)高于对照组患儿(12.24%),但比较差异无统计学意义(χ2=0.09,P=0.76)。综上说明脾氨肽联合更昔洛韦治疗小儿巨细胞病毒感染的效果较好,能有效纠正T淋巴细胞亚群失衡、降低CMV-DNA载量,且使用安全,值得在临床推广使用。To investigate the effects of spleen ammonia peptide combined with ganciclovir on blood T lymphocyte subsets and urine CMV-DNA loading in children with cytomegalovirus infection,98 children with cytomegalovirus infection were divided into observation group and control group according to the random number method.All children were given symptomatic support treatment before,receiving ganciclovir intravenous infusion treatment,on this basis,the children of observation group were given oral spleen ammonia peptide combination therapy for 4 weeks.The results showed that the total effective rate was 89.80%in the observation group and 73.47%in the control group（χ^2= 4.36,P = 0.04）.Both peripheral CD4^＋and CD4^＋/CD8^＋T cells proportion elevated after treatment（P〈0.01）.The levels of CD8^＋T cells in the two groups were significantly lower than those before treatment and the levels of CD8^＋T cells in the observation group were significantly lower than those in the control group（P〈0.01）.There was no significant difference between the two groups（P〈0.05）,and the difference was statistically significant（P〈0.01）.The incidence of adverse reactions（14.29%）was higher than that of the control group（12.24%）,but the difference was not statistically significant（χ^2= 0.09,P = 0.77）.In conclusion,the therapeutic effect of spleen ammonia peptide combined with ganciclovir in the treatment of cytomegalovirus infection in children is good,which can effectively modulate the imbalance of T lymphocyte subsets and reduce the CMV-DNA load,and is safe and worthy to be used in clinical practice.

关 键 词：脾氨肽 更昔洛韦 小儿巨细胞病毒感染 T淋巴细胞亚群 CMV-DNA载量 

分 类 号：R725.1[医药卫生—儿科]