带状疱疹抗病毒药物的合理选择  

Reasonable selection of antiviral agents for herpes zoster

作　　者：王兴旺 杨慧兰 Wang Xingwang;Yang Huilan(Department of Dermatology,General Hospital of Southern Theater Command of PLA,Guangzhou 510010,China)

机构地区：[1]解放军南部战区总医院皮肤科,广州510010

出　　处：《中华皮肤科杂志》2023年第3期262-265,共4页Chinese Journal of Dermatology

摘　　要：抗病毒治疗是带状疱疹治疗的核心,本文结合最新研究、共识和指南,探讨抗病毒药物种类和剂量的合理选择。伐昔洛韦口服生物利用度高,且用药更方便,一般是口服抗病毒药物的首选;而对于一些特殊情况,如免疫力低下患者,应酌情选择静脉滴注阿昔洛韦。对于严重肾功能不全的患者,溴夫定往往是更好的选择;对阿昔洛韦耐药的患者应考虑使用泛昔洛韦或者其他抗病毒药物治疗;而对于免疫力低下同时合并阿昔洛韦耐药的患者可选择静脉滴注膦甲酸钠。使用口服抗病毒药应达到足够的剂量。选择合适的抗病毒药物及剂量能有效缓解患者急性期症状,同时降低发生带状疱疹后神经痛的可能性。Antiviral treatment is the core part in the treatment of herpes zoster.Based on the latest studies,consensus and guidelines,this article aims to provide a basis and reference for clinicians to make a reasonable choice of types and doses of antiviral agents.Valacyclovir,a precursor of acyclovir with high oral bioavailability and great convenience of administration,is generally the first choice of oral antiviral agents;for some special cases,such as immunocompromised patients,intravenous drips of acyclovir should be selected when appropriate.Brivudine is often a better choice for patients with severe renal insufficiency;famciclovir or other antiviral agents should be considered for patients resistant to acyclovir;for immunocompromised patients resistant to acyclovir,intravenous drips of foscarnet sodium can be an option.Oral antiviral agents should be administered at adequate doses.Selecting appropriate antiviral agents and their doses can effectively relieve acute symptoms of patients and reduce the probability of postherpetic neuralgia.

关 键 词：带状疱疹 抗病毒药 阿昔洛韦 伐昔洛韦 泛昔洛韦 溴夫定 膦甲酸钠 剂量 疗程 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]