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目的:观察更昔洛韦治疗婴儿巨细胞病毒(CMV)肝炎的临床疗效及对细胞因子IL-8和IFN-γ的影响。方法:76例CMV肝炎婴儿随机分为治疗组和对照组。对照组给予常规保肝、退黄对症治疗,治疗组在保肝、退黄对症治疗的基础上给予更昔洛韦诱导期治疗和维持期治疗的治疗方案。观察治疗前后黄疸消长、肝功能、药物不良反应、IL-8和IFN-γ水平的改变,评价临床疗效。结果:治疗组临床疗效总有效率为91.4%,显著高于对照组(71.4%),相比较有统计学差异(P<0.05);治疗后,治疗组黄疸(TBIL和DBIL)水平、转氨酶(ALT和AST)和细胞因子(IL-8和IFN-γ)水平下降,与治疗前和对照组比较均有差异(P<0.05)。治疗组无不良反应。结论:更昔洛韦治疗CMV肝炎婴儿能使机体特异性细胞免疫功能恢复平衡;能显著改善黄疸症状和肝功能,临床疗效好,值得临床推广应用。
Objective: To observe the clinical efficacy of ganciclovir in the treatment of infant cytomegalovirus (CMV) hepatitis and its effects on cytokines IL-8 and IFN-γ. Methods: 76 cases of CMV hepatitis were randomly divided into treatment group and control group. The control group was given routine hepatoprotective and antipyretic symptomatic treatment. The treatment group was treated with the induction and treatment of ganciclovir on the basis of hepatoprotective and anti-yellowing symptomatic treatment. Observed before and after treatment jaundice growth and decline, liver function, adverse drug reactions, IL-8 and IFN-γ levels change, evaluate the clinical efficacy. Results: The total effective rate of the treatment group was 91.4%, which was significantly higher than that of the control group (71.4%) (P <0.05). After treatment, the levels of TBIL and DBIL, ALT and AST) and cytokines (IL-8 and IFN-γ) levels decreased compared with before treatment and control group (P <0.05). The treatment group without adverse reactions. Conclusion: Ganciclovir treatment of CMV hepatitis baby can make the body-specific cellular immune function return to balance; can significantly improve the symptoms of jaundice and liver function, clinical efficacy is good, worthy of clinical application.