长疗程抗病毒治疗对传染性单核细胞增多症患儿EBV抑制的影响  

Effect of Long-Term Antiviral Therapy on EBV Inhibition in Children with Infectious Mononucleosis

作　　者：任高伟[1] 刘灵[1] 李明丽[1] 黄伟[1] 夏明月[1] REN Gao-wei;LIU Ling;LI Ming-li;HUANG Wei;XIA Ming-yue(Department of Pediatrics,Qinhuangdao No.1 Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院儿科,河北秦皇岛066000

出　　处：《药物生物技术》2019年第6期516-520,共5页Pharmaceutical Biotechnology

摘　　要：探讨长疗程抗病毒治疗对传染性单核细胞增多症(Infectious mononucleosis,IM)患儿EBV抑制的影响。选择该院2016年1月至2019年1月期间收治IM患儿108例作为研究对象,根据疗程不同将患者分为研究组(抗病毒治疗14 d)和对照组(抗病毒治疗7 d),各54例。采用荧光定量聚合酶链反应(Fluorescence quantitative polymerase chain reaction,FQ-PCR)试验检测EBV-DNA浓度,采用酶联免疫吸附试验(Enzyme linked immunosorbent assay,ELISA)测定EBVCA-IgM。研究组治疗总有效率明显高于对照组,P <0. 05。两组淋巴结肿大消退时间、脾肿大消退时间、退热时间和咽峡炎消退时间比较差异无统计学意义(P> 0. 05),研究组肝肿大消退时间和ALY恢复正常时间明显短于对照组,P <0. 05。治疗前,两组血清EBV-DNA、EBVCA-IgM阳性率比较差异无统计学意义(P> 0. 05),治疗后6个月,两组上述指标较治疗前明显降低(P <0. 05),研究组上述指标较对照组明显降低(P <0. 05)。治疗期间,两组药物不良反应率比较差异无统计学意义(P> 0. 05),且均在停药后自行缓解,治疗后持续随访6个月,研究组复发率明显低于对照组(P <0. 05)。结果提示长疗程抗病毒治疗有利于明显缓解IM患儿临床症状,有效抑制EBV复制,进而降低复发风险,且不增加药物不良反应风险。To investigate the effect of long-term antiviral treatment on EBV inhibition in children with Infectious mononucleosis( IM),108 cases of IM children admitted to the hospital from 2016-01 to 2019-01 were selected as research objects. According to different treatment-terms,patients were divided into study group( 14 d antiviral therapy) and control group( 7 d antiviral therapy),with 54 cases in each. EBV-DNA concentration was detected by fluorescence quantitative polymerase chain reaction( fq-pcr) assay,and EBVCA-IgM was detected by enzyme linked immunosorbent assay( ELISA). The total effective rate of the study group was significantly higher than that of the control group,P < 0. 05. There was no significant difference in resolution time of lymph node enlargement,splenomegaly,fever and pharyngeal isthmus between the two groups( P > 0. 05). The hepatomegaly resolution time and ALY normal recovery time of the study group were significantly shorter than those in the control group( P < 0. 05). Before treatment,there was no statistically significant difference in serum EBV-DNA,EBVCA-IgM between the two groups( P > 0. 05). Six months after treatment,the above indicators in the two groups were significantly lower than those of pre-therapy( P < 0. 05),while the above indicators of the study group were significantly lower than those in the control group( P < 0. 05). During the treatment period,there was no statistically significant difference in adverse drug reactions rate between the two groups( P > 0. 05),which were all spontaneously relieved after drug withdrawal. The follow-up was continued for 6 months after the treatment,and recurrence rate of the study group was significantly lower than that of the control group( P < 0. 05). Long-term antiviral therapy is beneficial to significantly alleviate clinical symptoms of IM children and effectively inhibit proliferation of EBV,thus reducing recurrence risk,and does not increase adverse drug reactions risk,which is worthy of clinical promotion and application.

关 键 词：传染性单核细胞增多症 抗病毒治疗 EPSTEIN-BARR病毒 病毒抑制 EBV-DNA EBVCA-IgM 

分 类 号：R725.1[医药卫生—儿科]