更昔洛韦治疗小儿巨细胞病毒肺炎疗效观察
Study on the therapeutic effect of ganciclovir on children with cytomegalovirus pneumonia
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摘要: 目的: 探讨小儿巨细胞病毒(CMV)肺炎临床特点及更昔洛韦的治疗效果。方法: 回顾性分析46例小儿CMV肺炎的临床特点,并观察30例小儿CMV肺炎更昔洛韦治疗前后临床症状、体征、肝脾大小、丙氨酸氨基转移酶(ALT)、胸片变化以及药物不良反应。结果: 小儿CMV肺炎以小婴儿发病多见,多以咳嗽为首发表现就诊(82.61%),且病程较长,有的表现为痉挛样咳。多为间质性肺炎(80.43%)。常合并有肺外表现。应用更昔洛韦5~7.5mg/kg,每12h静滴1次,治疗14天,临床症状、体征消失或明显好转,肝脾回缩,血清ALT降低,胸片吸收好转,总有效率达93.33%,未见更昔洛韦的明显副作用。结论: 对咳嗽时间较长的患儿,尤其有合并症的小婴儿应警惕CMV肺炎。更昔洛韦5~7.5mg/kg,每12h静滴1次治疗,安全、有效、副作用小。Abstract: Objective: To investigate the clinical features of cytomegalovirus(CMV) pneumonia and the therapeutic effect of ganciclovir(GCV)in treatment of the disease.Methods: The clinical features of 46 children with CMV pneumonia were analyzed retrospectively.The clinical symptom,sign,ALT,chest radiographs,and the size of liver and spleen were detected before and after GCV therapy.Results: Cough was the most common symptom of CMV pneumonia in infants(82.61%).CMV pneumonia cases showed interstitial pneumonia(80.43%).Children with CMV pneumonia more often had liver and spleen involvement.After 14 days of GVC(from 5 to 7.5 mg/kg Q12h intravenous infusion) therapy,the clinical symptom,sign,chest radiographs,enlarged liver and spleen,and liver function improved.No obvious adverse effect was observed during the therapy.Conclusions: CMV pneumonia should be considered in infants with cough and complications.GCV is safe and effective in treatment of CMV infection.
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