婴儿巨细胞病毒肝炎的临床特征及更昔洛韦疗效评价(附50例分析)  

Analysis of clinical features of infant cytomegalovirus hepatitis and the effect of ganciclovir on it

作　　者：方昕[1] 华雪玲[1] 陈征[1] 李健[1] 乐少华[1] 

机构地区：[1]福建医科大学附属协和医院儿内科,350001

出　　处：《福建医药杂志》2003年第3期50-52,共3页Fujian Medical Journal

摘　　要：目的　分析婴儿巨细胞病毒 (CMV)肝炎的临床特征及更昔洛韦的治疗效果。方法　回顾性分析 5 0例婴儿 CMV肝炎的临床特征。1999年 1月至 2 0 0 0年 12月住院的 30例患儿单纯用保肝退黄治疗 14天 ;2 0 0 1年 1月至 2 0 0 2年 12月住院的 2 0例患儿除保肝退黄治疗外加用更昔洛韦诱导抗病毒治疗 ;分别对比两组治疗前后血清总胆红素和肝酶 (AL T、γ- GT、 AKP)水平及肝脾大小的变化 ,同时观察更昔洛韦的不良反应。结果　婴儿 CMV肝炎大部分以黄疸为首发表现就诊 ,但也有以其它系统损害症状就诊者。先天性感染者易合并先天畸形 ,可导致胆道梗阻 ,预后差 ;一般的保肝退黄治疗婴儿 CMV肝炎效果差 ;加用更昔洛韦抗病毒治疗 ,血清总胆红素、 AL T、γ- GT水平下降、肝脾回缩 ,差别有显著性统计学意义 (P<0 .0 5 )。 1例患儿更昔洛韦治疗后出现粒细胞及血小板减少 ,停药后很快恢复。结论　婴儿巨细胞病毒肝炎临床表现多样 ,常合并其它系统和脏器的损害。先天性感染危害尤大 ,更昔洛韦治疗 CMV肝炎短期内较为安全有效 。Objective\ To analyze the clinical features of infant cytomegalovirus(CMV)hepatitis and the effect of ganciclovir on it.Methods\ The clinical features of 50 infants with CMV hepatitis were retrospected.Fifty patients were divided into two groups.Thirty patients in the first group were given routine drugs that helped protect liver and reduce jaundice for 14 days.Twenty patients in the second group were given the same drugs as well as ganciclovir(5mg/kg q12h intravenous infusion)for 14 days.Serum levels of TBIL,ALT,γ GT,AKP and the size of livers and spleens were measured before and after therapy in each group.The side effects of ganciclovir were also observed.Results\ Jaundice was the most common complaint of infants with CMV hepatits,but other untypical symptoms could also be the complaints.Patients with congenital infection often had deformity and biliary obstruction. The effects of routine drugs were poor for infants with CMV hepatitis in the first group.After the antiviralagent ganciclovir was added in the second group the patients'liver funtions were greatly improved as well as enlarged livers and spleens diminished.Only one patient had neutropenia and thrombocytopenia after therapy.Conclusion\ The clinical features of infant CMV hepatitis very wide.Congenital infection is the most dangerous.Ganciclovir is a safe and effective agent to treat CMV infection according to a short term observation,but further reserch is needed.

关 键 词：巨细胞病毒肝炎 婴儿 临床特征 更昔洛韦 疗效评价 

分 类 号：R725.1[医药卫生—儿科]