更昔洛韦与病毒唑治疗小儿水痘的疗效比较

目的:探讨更昔洛韦与病毒唑治疗小儿水痘的临床疗效。方法:将120例水痘患儿随机分为两组,更昔洛韦 组、病毒唑组各60例。更昔洛韦组给予更昔洛韦5mg/(kg·d)静滴,每日1次治疗;病毒唑组给予病毒唑10mg/ (kg·d)静滴,每日1次治疗。两组均计数退热时间及皮疹结痂时间,同时观察药物的毒副作用。结果:更昔洛韦 组平均退热时间为(2.61±0.47)d,明显少于病毒唑组(3.7±0.38)d(P<0.05);皮疹结痂时间,更昔洛韦组为 (3.24±0.27)d,明显少于病毒唑组(4.3±0.31)d(P<0.05)。两组药物治疗过程中无明显毒副作用。结论:更昔 洛韦治疗小儿水痘疗效显著,明显优于病毒唑。     

Valganciclovir is an effective prophylaxis for cytomegalovirus disease in liver transplant recipients

Objectives:

Cytomegalovirus (CMV) infection is responsible for significant morbidity and mortality among solid organ transplant recipients. Prophylaxis using valganciclovir (VGCV) in orthotopic liver transplant (OLT) recipients is not approved by the Food and Drug Administration and its use is controversial. This study aimed to evaluate the effectiveness of VGCV in CMV prophylaxis in OLT recipients.

Methods:

We carried out a retrospective, single-centre study including all OLT procedures performed during 2005–2008. Patients with early death (at ≤30 days), without CMV serology or prophylaxis, or with follow-up of <1 year were excluded.

Results:

The overall incidence of CMV disease was 6% (n = 9). The ganciclovir (GCV) and VGCV groups had similar incidences of CMV disease (4.6% vs. 7.0%; P = 0.4) and similar distributions of disease presentation (CMV syndrome vs. tissue-invasive CMV; P = 0.4). Incidences of CMV infection, as well as disease presentation, were similar between the high-risk (CMV D+/R−) and non-high-risk groups (P = 0.16). Although acute cellular rejection occurred more frequently in patients who developed CMV disease (P = 0.005), overall survival in these patients did not differ from that in patients who did not develop CMV infection (P = 0.5).

Conclusions:

Valganciclovir is an effective antiviral for the prevention of CMV disease in liver transplant recipients. Our data support its use in high-risk OLT patients.     

更昔洛韦联合胸腺肽治疗小儿巨细胞病毒感染疗效分析

目的探究更昔洛韦联合胸腺肽在HCMV感染的小儿患者治疗中的临床应用价值。方法采用前瞻性开放研究,共收集80例在我院就诊的人类巨细胞病毒(HCMV)小儿患者,分别进行更昔洛韦联合胸腺肽治疗和单用更昔洛韦治疗,经统计学分析比较两组治疗的总有效率和不良反应发生率。结果将二者总有效率和不良反应率采用SPSS18.0统计软件进行卡方检验后,差异均有统计学意义(P值均<0.05)。结论更昔洛韦与胸腺肽联合治疗小儿巨细胞病毒感染的疗效明显优于单用更昔洛韦治疗,且其不良反应明显低于后者,因此值得在临床上推广应用。     

回顾性分析本院用更昔洛韦与阿昔洛韦治疗单纯疱疹病毒性角膜炎的疗效

目的 回顾性分析本院用更昔洛韦与阿昔洛韦治疗单纯疱疹病毒性角膜炎的疗效.方法 收集近年在本院门诊就诊的100例(106眼)单纯疱疹病毒性角膜炎患者,其中48例用更昔洛韦眼用凝胶;37例用阿昔洛韦眼液.比较两者疗效.结果 更昔洛韦组与阿昔洛韦组总有效率分别为91.7%,75.7%,显示更昔洛韦眼用凝胶的有效率好于阿昔洛韦眼液(P＜0.05).结论 更昔洛韦眼用凝胶治疗单纯疱疹病毒性角膜炎的效果较好.     

穿琥宁联合更昔洛韦治疗儿童传染性单核细胞增多症疗效观察

目的 观察穿琥宁联合更昔洛韦治疗儿童传染性单核细胞增多症的临床疗效。方法 将76 例患者按照随机原则分为治疗组38例和对照组38例,治疗组采用穿琥宁和更昔洛韦联合治疗,对照组单独使用更昔洛韦治疗,进行临床疗效对比观察。结果 治疗组的临床症状、体征消退,异型淋巴细胞消失;热退时间均明显少于对照组,疗效明显优于对照组,差异有显著意义(P<0.05)。结论 穿琥宁联合更昔洛韦治疗儿童传染性单核细胞增多症可有效缩短退热时间,疗效显著,作用安全,值得临床推广应用。     

9L-rIL12-TK大鼠胶质瘤基因免疫疫苗的安全可控性体内实验研究

目的评估9L-rIL12-TK脑胶质瘤基因免疫活细胞疫苗在体内的安全可控性。方法将40只裸鼠随机分成3组,分别于右侧腋部皮下接种9L-rIL12-TK细胞（n=14）、9L-TK细胞（n=14）和9L细胞（n=12）,7d后将各组裸鼠分成两亚组,实验组（n=8,8,6）给予更昔洛韦（GCV）干预实验,对照组（均n=6）给予生理盐水注射,连续7d;观察裸鼠瘤体生长情况和生存时间,60d后取瘤结节及全身脏器行组织学检查（苏木精-伊红染色）。结果①给予GCV干预后7d,9L-rIL12-TK实验组及9L-TK实验组裸鼠瘤体平均体积较相应对照组及9L组显著性缩小（均P〈0.05）。60d时,8只9L-rIL12-TK实验组裸鼠瘤体均完全消退,且均无复发;8只9L-TK实验组裸鼠中,瘤体完全消退3只,瘤体缩小后再次增大5只;余亚组瘤体均呈增大趋势。②GCV干预后,9L-rIL12-TK实验组和9L-TK实验组与相应对照组比较,生存时间明显延长（P〈0.05）。③9L-rIL12-TK实验组和9L-TK实验组无瘤裸鼠接种部位无异型性肿瘤细胞,余裸鼠瘤体内均见异型性肿瘤细胞;所有裸鼠相关脏器病理学检查均未见肿瘤远处转移征象。结论9L-rIL12-TK大鼠胶质瘤细胞基因免疫疫苗在裸鼠体内可得到安全有效的控制,使制备免疫原性强且安全有效的胶质瘤基因免疫活细胞疫苗策略成为可能;其基因免疫治疗效应有待进一步研究。     

更昔洛韦联用西咪替丁治疗婴幼儿轮状病毒性肠炎的疗效观察

目的探讨更昔洛韦联用西咪替丁对婴幼儿轮状病毒性肠炎的治疗效果。方法将婴幼儿轮状病毒性肠炎116例随机分为4组,4组均给予补液,维持电解质平衡治疗。治疗组用更昔洛韦5mg·kg^-1·d^-1、西咪替丁10～15mg·kg^-1·d^-1静脉滴注,对照1组为空白对照组,对照2组用西咪替丁10～15mg·kg^-1·d^-1静脉滴注,对照3组用更昔洛韦5mg·kg^-1·d^-1静脉滴注,均一天一次,3d为一疗程。结果治疗组、对照1组、对照2组、对照3组总有效率分别为91．1％、45．0％、70．3％、86．6％。治疗组与对照1、2组总有效率比较,有显著性差异（P〈0．05）;治疗组与对照3组总有效率比较无显著性差异（P〉0．05）;4组在用药后症状改善时间上有显著性差异（P〈0．01）。结论更昔洛韦联用西咪替丁联合治疗婴幼儿轮状病毒肠炎疗效较好,值得临床应用。     

以更昔洛韦为主综合治疗婴幼儿毛细支气管炎

目的 为了探讨以静脉注射更昔洛韦为主综合治疗婴幼儿毛细支气管炎的临床疗效。方法 将78例毛细支气管炎患儿随机分为两组,观察组给予更昔洛韦治疗,对照组给予病毒唑治疗,并均佐以镇静、吸氧、超雾、止咳化痰、激素治疗、预防应用抗茵素等,对照两组方法治疗毛细支气管炎前后症状体征平均持续时间,疗效及观察治疗前后实验室指标如血常规及C-反应蛋白,胸部X线检查,支原体抗体测定及衣原体抗原测定,病毒血清学检测结果。结果 观察组气促缓解时间,肺部罗音、哮鸣音咳嗽消失时间,住院日及疗效与对照组比较均有显著差异性(P<0.01)。结论 更昔洛韦对于抗病毒疗效显著,作用迅速,抗病毒谱广,临床应用的安全性也相对较好,短期应用无明显的骨髓抑制作用。每日更昔洛韦(10 mg/kg)有较好的病毒抑制作用,为今后治疗病毒感染的研究提供了广阔的前景,值得推广应用。     

Clinical Utility of Cytomegalovirus Viral Load Testing for Predicting CMV Disease in D+/R- Solid Organ Transplant Recipients

Despite prophylaxis, cytomegalovirus (CMV) disease is common in donor seropositive (D+)/recipient seronegative (R-) transplant patients after cessation of prophylaxis. Early detection of CMV may allow for pre-emptive therapy to prevent active disease. The clinical utility of quantitative plasma viral load measurements for predicting CMV disease was determined in 364 D+/R- organ transplant patients receiving prophylaxis (100 d of valganciclovir or oral ganciclovir). Measurements were performed every 2 weeks until day 100 and at months 4, 4.5, 5, 6, 8 and 12 post-transplant. CMV disease occurred in 64 (17.6%) patients by 12 months. Using a positive cut-off value of >400 copies/mL, sensitivity was 38%, specificity 60%, positive predictive value 17%, and negative predictive value 82% for prediction of CMV disease. Therefore, routine monitoring would have predicted disease in only 24/64 (38%) patients. The test characteristics were not improved by changing the viral load cut-off point for defining a positive result. Similarly, single time point measures at the end of prophylaxis or month 4 had low sensitivity for disease prediction. Overall, regular CMV plasma viral load measurements were only of modest value in predicting CMV disease.