复方甘草酸苷注射液联合腺苷蛋氨酸治疗婴儿巨细胞病毒性肝炎的临床研究  

Compound glycyrrhizin injection combined with ademetionine in treatment of infantile cytomegalovirus hepatitis

作　　者：房文彬 袁艳平 刘凯 Fang Wenbin;Yuan Yanping;Liu Kai(Department of Pediatrics,Shanxian Central Hospital,Heze 274300,China)

机构地区：[1]单县中心医院儿科,菏泽274300

出　　处：《国际医药卫生导报》2018年第24期3810-3813,共4页International Medicine and Health Guidance News

摘　　要：目的 观察复方甘草酸苷注射液联合腺苷蛋氨酸治疗婴儿巨细胞病毒性(CMV)肝炎的临床疗效。方法 选取2017年1月至2018年1月CMV性肝炎患儿68例,采用数字随机分组法分为两组,各34例。对照组给予更昔洛韦,研究组在对照组基础上加用复方甘草酸苷注射液联合腺苷蛋氨酸,两组均治疗14 d。观察两组临床疗效,记录治疗前后肝脾大小,血清总胆红素(STB)水平、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)水平,血巨细胞病毒-IgM(CMV-IgM)抗体和巨细胞病毒脱氧核苷酸(CMV-DNA)阳性率,以及不良反应情况。结果 研究组总有效率97.1%(33/34)高于对照组82.4%(28/34),差异有统计学意义(P<0.05);治疗后,研究组肝脏大小降低值[(2.02±0.25)cm比(1.09±0.34)cm],明显高于对照组,差异有统计学意义(P<0.05),脾脏大小降低值[(1.34±0.23)cm比(0.75±0.33)cm],明显高于对照组,差异有统计学意义(P<0.05);治疗后,两组STB、ALT、AST水平均较同组治疗前降低,差异均有统计学意义(均P<0.05);治疗后,研究组STB、ALT、AST水平分别为(67.5±34.8)U/L、(73.9±22.7)U/L、(45.1±21.6)mmol/L,明显低于对照组(125.3±41.6)U/L、(135.7±25.8)U/L、(96.8±30.8)mmol/L,差异均有统计学意义(均P<0.05);治疗后,研究组CMV-IgM、CMV-DNA阳性率14.7%、17.6%,明显低于对照组67.6%、64.7%,差异均有统计学意义(均P<0.05);两组临床不良反应比较,差异无统计学意义(P>0.05)。结论 复方甘草酸苷注射液联合腺苷蛋氨酸可明显降低巨细胞病毒性肝炎患儿肝脾肿大症状,STB、ALT、AST水平,降低血CMV-IgM抗体和CMV-DNA阳性率,提高治疗有效率。Objectives To observe the clinical efficacy of compound glycyrrhizin injection combined with ademetionine in the treatment of infantile cytomegalovirus(CMV)hepatitis.Methods A total of 68 infants with cytomegalovirus hepatitis who met the inclusion criteria and were treated at our hospital from January,2017 to January,2018 were randomly divided into a control group and a study group,34 cases for each group.The control group were treated with ganciclovir,and the study group with ganciclovir,compound glycyrrhizin injection,and ademetionine.The 2 groups were treated for 14 days.The liver and spleen size,serum total bilirubin(STB),alanine aminotransferase(ALT),and aspartate aminotransferase(AST),serum CMV-IgM antibody,and CMV-DNA positive rate were observed and recorded before and after the treatment.Results The total effective rate was 97.1%(33/34)in the study group,and 82.4%(28/34)in the control group,with a statistical difference(P<0.05).After the treatment,the liver size and the spleen size decreased more in the study group than in the control group[(2.02±0.25)cm vs.(1.09±0.34)cm and(1.34±0.23)cm vs.(0.75±0.33)cm,both P<0.05].The levels of STB,ALT,and AST were lower after than before the treatment in both groups,with statistical differences(all P<0.05).After the treatment,the levels of STB,ALT,and AST and the positive rates of CMV-IgM and CMV-DNA were significantly lower in the study group than in the control group[(67.5±34.8)U/L vs.(125.3±41.6)U/L,(73.9±22.7)U/L vs.(135.7±25.8)U/L,(45.1±21.6)mmol/L vs.(96.8±30.8)mmol/L,14.7%vs.67.6%,and 17.6%vs.64.7%],with statistical differences(all P<0.05).There was no statistical difference in the incidence of clinical adverse reactions between the 2 groups(P>0.05).Conclusions Compound glycyrrhizin injection combined with ademetionine for infantile cytomegalovirus hepatitis can significantly reduce their symptoms of hepatosplenomegaly,levels of STB,ALT,and AST,and positive rates of blood CMV-IgM antibody and CMVDNA,and improve the treatment efficacy.

关 键 词：婴儿 肝炎 巨细胞病毒 腺苷蛋氨酸 复方甘草酸苷注射液 

分 类 号：R725.1[医药卫生—儿科]