喜炎平注射液联合更昔洛韦治疗儿童巨细胞病毒肺炎疗效观察

目的:探讨喜炎平注射液联合更昔洛韦(GCV) 治疗小儿巨细胞病毒(CMV)肺炎的方法及效果。方法:选取我院2010年3月至2016年5月住院确诊的CMV肺炎患儿47例,随机分为观察组24例和对照组23例。对照组在常规治疗基础上加用GCV抗病毒治疗:诱导期每次5 mg/kg,每12 h一次静脉滴注,每次滴注时间>1 h,连用2周;维持期每次10 mg/kg,隔日一次,总疗程4周。观察组在常规治疗基础上加用喜炎平联合GCV治疗,GCV用法用量疗程同对照组,喜炎平注射液5 mg/(kg·d)静脉滴注,每天1次,疗程2周。观察两组患儿临床疗效及预后。结果:(1) 观察组在退热时间、住院时间短于对照组(P均<0.01)。治疗2周后,观察组肺部啰音及影像学改变阳性率低于对照组,血氧分压、二氧化碳分压的改善程度均优于对照组(P均<0.05);(2)治疗2周后两组总有效率比较差异无统计学意义(P>0.05),但观察组显效率高于对照组(62.5% vs 30.4%,P<0.05);(3)两组不良反应比较差异无统计学意义(P>0.05)。结论:小儿CMV肺炎在常规综合治疗、GCV抗病毒治疗同时,联合喜炎平注射液,可提高显效率、缩短疗程、改善预后,且具有较高安全性。

Xiyanping with Ganciclovir Treated Children with Cytomegalovirus Pneumonia

Objective: To investigate the method and effect of Xiyanping combined with ganciclovir ( GCV) in children with Cytomegalovirus (CMV) pneumonia. Methods: Forty-seven children with CMV pneumonia were divided into observation group (24 cases) and control group (23 cases). The control group was treated with antiviral therapy of GCV: children in induction period were given 5 mg/kg GCV intravenous drip each time, once every 12 hours, infusion time was >1 h, the course of treatment lasted for 2 weeks. Children in maintenance period were given 10 mg/kg GCV intravenous drip each time, once every other day, the course of treatment lasted for 4 weeks. The observation group was given Xiyanping combined with GCV treatment. Usage and dosage of GCV in the two groups were the same. Children in treatment group were given Xiyanping 5 mg/ kg intravenous drip, once every day, course of treatment for 2 weeks. The therapeutic effects and prognosis of the two groups were observed. Results: Compared with the control group, the defervescence day and hospitalization day were shorter (P<0.01), the positive rates of pulmonary rale and imaging change of lung were lower, partial pressure of blood oxygen and carbon dioxide were significantly better than the observation group (P<0.05). After two weeks of treatment, the total effective rate between the two groups was not different (P>0.05), while the obvious effective rate of observation group was significantly higher than that of control group (62.5% vs 30.4%, P<0.05). The adverse reaction between the two groups had no statistical significance (P>0.05). Conclusion: The treatment of conventional GCV combined with Xiyanping not only improved the cure rate and prognosis, but also cut down hospitalization course in children with CMV pneumonia, furthermore, its security is reliable.