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目的了解婴儿肝炎综合征的人巨细胞病毒 (CMV)感染情况 ;探讨更昔洛韦治疗CMV肝炎的临床效果。方法对 117例临床诊断婴儿肝炎综合征患儿进行血清HCMV IgM和CMV DNA(PCR法 )检测 ;将HCMV IgM或CMV DNA阳性的患儿随机分成两组 ,对照组给予病毒唑 [10～ 15mg/(kg·d) ,静滴 ,10～ 14天 ],治疗组给予更昔洛韦 [5～7.5mg/(kg·d) ,静滴 ,10～ 14天 ],其余对症治疗相同 ;观察患儿CMV感染转阴率及临床症状缓解情况。 结果①婴儿肝炎综合征患儿CMV感染率是 4 1.88% ;②治疗组CMV感染总转阴率 (85 .71% )明显高于对照组 (30 .4 3% ) ;③治疗组总有效率 (85 .19% )明显高于对照组 (31.82 % ) ;④治疗组血清胆红素恢复正常时间是 (13.4 8± 11.0 3)天 ,对照组是(2 4 .0 8± 7.34)天 ,丙氨酸氨基转移酶恢复正常时间是 (34.4 8± 11.0 3)天 ,对照组是 (48.6 7± 9.11)天 ,治疗组临床症状恢复正常时间明显短于对照组 ;⑤治疗组不良反应率 (33.33% )与对照组 (2 7.2 7% )比较无显著性差异。结论更昔洛韦治疗婴儿肝炎综合征安全、有效。
Objective To understand the infection of human cytomegalovirus (CMV) in infantile hepatitis syndrome and explore the clinical effect of ganciclovir on CMV hepatitis. Methods Serum HCMV IgM and CMV DNA (PCR) were detected in 117 clinically diagnosed infantile hepatitis syndromes. The children with positive HCMV IgM or CMV DNA were randomly divided into two groups. The control group received Ribavirin [10-15 mg / (kg · d), intravenous infusion, 10 to 14 days]. The patients in the treatment group were treated with ganciclovir [5-7.5 mg / (kg · d), iv, 10-14 days] Children infected with CMV negative conversion rate and clinical symptom relief. Results ① The infection rate of CMV in infants with hepatitis syndrome was 4 1.88%. ② The total negative conversion rate (85.71%) of CMV infection in treatment group was significantly higher than that in control group (30.33%). ③ The total effective rate (85.19%) was significantly higher than that of the control group (31.82%). The serum bilirubin recovery time was (13.4 8 ± 11.0 3) days in the treatment group and (24.08 ± 7.34) days in the control group, (34.4 8 ± 11.0 3) days, the control group was (48.6 7 ± 9.11) days, the clinical symptoms of the treatment group returned to normal time was significantly shorter than the control group; ⑤ The adverse reaction rate of the treatment group ( 33.33%) compared with the control group (7.222%) no significant difference. Conclusion Ganciclovir is safe and effective in treating infantile hepatitis syndrome.