干扰素1b联合更昔洛韦治疗传染性单核细胞增多症的临床研究  

Therapeutic effects of interferon α1b atomization inhalation combined with ganciclovir on infectious mononucleosis

作　　者：毕晶[1] 夏明倩[1] 王冬萌[1] 蒋婷婷 甄玮娜 楚永涛[1] 杨晓轩[1] 侯跃慧 王慧 王天宜 汤鹤 楚晶晶 李晨曦 BI Jing;XIA Mingqian;WANG Dongmeng(Baoding Children’s Hospital,Hebei,Baoding 071000,China)

机构地区：[1]河北省保定市儿童医院感染内科

出　　处：《河北医药》2019年第11期1609-1613,共5页Hebei Medical Journal

摘　　要：目的观察干扰素1b雾化吸入联合更昔洛韦治疗传染性单核细胞增多症(IM)的临床疗效、安全性及对免疫功能的影响。方法选择2017年10月至2018年10月收治的160例IM患儿作为研究对象,按收治顺序将患儿随机分为试验组(n=80)和对照组(n=80),2组均采用对症处理,对照组在综合治疗的基础上给予更昔洛韦5 mg·kg-1·次-1,加入1 L/g的0.9%氯化钠溶液稀释静脉滴注(≥1 h),每12小时1次,连续给药10 d,试验组在对照组的基础上雾化吸入注射用重组人干扰素α1b 1~2μg·kg-1·次-1,加入2 ml 0.9%氯化钠溶液稀释,每次15 min,2次/d,连续治疗7 d,记录症状消失时间、异型淋巴细胞恢复正常的时间及住院时间,治疗结束后评价2组临床疗效,治疗前、治疗后10 d进行细胞免疫(CD3+、CD4+/CD8+)和体液免疫指标(IgA、IgG)检测,观察不良反应发生情况。结果试验组患儿退热时间、咽峡炎症消失时间、颈部淋巴结肿大消退时间、肝脾肿大消退时间、异型淋巴细胞恢复正常的时间、住院时间均明显短于对照组,差异有统计学意义(t=6.078、8.413、6.686、7.468、8.384、4.021,P<0.05)。试验组总有效率明显高于对照组,差异有统计学意义(χ2=13.020,P<0.05)。对照组、试验组治疗后CD3+较治疗前明显下降(P<0.05),CD4+/CD8+、IgA、IgG较治疗前明显升高(P<0.05),试验组治疗后CD3+明显低于对照组(P<0.05),CD4+/CD8+、IgA、IgG明显高于对照组(P<0.05)。对照组不良反应发生率为10%,试验组为12.5%,差异无统计学意义(χ2=0.271,P>0.05)。结论干扰素α1b雾化吸入治疗IM的疗效确切、安全可靠,能有效改善机体细胞免疫异常状态,联合更昔洛韦治疗能起到协同作用,提高临床效果,未增加不良反应发生率。Objective To observe the therapeutic effects,safety of interferon α1 b atomization inhalation combined with ganciclovir on infectious mononucleosis(IM),and observe its effects on immune function of patients.Methods A total of 160 children patients with IM who were admitted and treated in our hospital from October 2017 to October 2018 were enrolled in the study,who were randomly divided into experimental group(n=80) and control group(n=80) according to the order of admission.The patients in both groups were treated symptomatically.On this basis the patients in control group were treated by ganciclovir 5 mg/kg adding 1 L/g 0.9% sodium chloride solution for intravenous drip(≥1 h),once per 12 hours,continuous administration for 10 days,and the patients in control group,on the basis of the control group,were treated by α1 b 1~2μg/kg via atomization inhalation after diluting in 0.9% sodium chloride solution 2 ml,15 min at a time,two times a day,continuous treatment for 7 days.The time of symptom disappearance,the time of the atypical lymphocytes putting back to normal levels and the length of staying in hospital were recorded.After treatment,the clinical effects were evaluated in both groups.In addition the cellular immunity indexes(CD3+, CD4+/CD8+) and humoral immunity indexes(IgA,IgG),and the incidence rate of adverse reactions were observed and compared between the two groups. Results The pyretolysis,the time oropharyngeal angina improvement,swollen cervical lymphadenectasis regression time, hepatosplenomegaly enlargement regression time,atypical lymphocyte recovery time as well as the length of staying in hospital in experimental group were significantly shorter than those in control group(P<0.05).The total effective rate in experimental group was significantly higher than that in control group(P<0.05). After treatment,the levels of CD3+ were decreased obviously in both groups(P<0.05),moreover,the levels of CD4+/CD8+.IgA and IgG in experimental group were significantly higher than those in control group(P<0.05

关 键 词：干扰素Α1B 传染性单核细胞增多症 免疫功能 临床疗效 

分 类 号：R512.7[医药卫生—内科学]