还原型谷胱甘肽联合更昔洛韦对巨细胞病毒肝炎患儿肝功能CMV DNA和T细胞亚群的影响  

Effects of Reduced Glutathione Combined with Ganciclovir on Liver Function,CMV DNA and T Cell Subsets in Children with Cytomegalovirus Hepatitis

作　　者：谭细妹 杨斌 祁云 梁朝霞 TAN Ximei;YANG Bin;QI Yun(Zhujiang Hospital, Southern Medical University, Guangdong Guangzhou 510000, China)

机构地区：[1]南方医科大学珠江医院,广东广州510000

出　　处：《河北医学》2022年第6期1024-1028,共5页Hebei Medicine

基　　金：广东省省级科技计划项目,(编号:2018B021800143)。

摘　　要：目的:分析还原型谷胱甘肽联合更昔洛韦对巨细胞病毒(CMV)肝炎患儿肝功能、CMV DNA和T细胞亚群的影响。方法:将本院2019年1月至2021年5月86例CMV肝炎患儿分为对照组(n=43)和联合组(n=43)。对照组采取还原型谷胱甘肽治疗,联合组采取还原型谷胱甘肽联合更昔洛韦治疗,比较两组患儿肝功能、CMV DNA和T细胞亚群的差异。结果:肝功能指标变化情况:治疗后1个月,两组患者血清TBil、GGT、AST、ALT的含量较治疗前均明显减少,且联合组TBil和GGT的含量较对照组均明显减少(均P<0.05)。尿CMV DNA转阴情况:联合组尿CMV DNA转阴时间较对照组明显缩短(P<0.05)。外周血T淋巴细胞亚群变化情况:治疗后1个月,两组患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)较治疗前明显升高,CD8^(+)较治疗前明显下降,且联合组CD4^(+)较对照组明显升高(均P<0.05)。结论:还原型谷胱甘肽联合更昔洛韦可有效减轻CMV肝炎患儿肝功能损害,促进肝功能恢复,值得临床应用。Objective:To analyze the effects of reduced glutathione combined with ganciclovir on liver function,CMV DNA and T cell subsets in children with cytomegalovirus(CMV)hepatitis.Methods:Totally 86 children with CMV hepatitis admitted to our hospital from January 2019 to May 2021 were divided into control group(n=43)and combined group(n=43).The control group was treated with reduced glutathione and the combined group was treated with reduced glutathione combined with ganciclovir.The differences of liver function,CMV DNA and T cell subsets between the two groups were compared.Results:Changes of liver function indexes:One month after treatment,the levels of TBil,GGT,AST,ALT in the two groups were significantly decreased compared with before treatment,and levels of TBil and GGT in the combined group was significantly decreased compared with the control group(P<0.05).Urine CMV DNA negative conversion:The negative time of urine CMV DNA in the combined group was significantly shorter than that in the control group(P<0.05).Changes of T lymphocyte subsets in peripheral blood:One month after treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were significantly higher than those before treatment,and the level of CD8+in the combined group was significantly decreased compared with the control group(P<0.05).Conclusion:Reduced glutathione combined with ganciclovir can effectively alleviate liver function damage and promote liver function recovery in children with CMV hepatitis,which is worthy of clinical application.

关 键 词：巨细胞病毒性肝炎 还原型谷胱甘肽 更昔洛韦 T细胞亚群 

分 类 号：R725.1[医药卫生—儿科]