更昔洛韦治疗小儿病毒性肺炎28例疗效观察

目的：观察更昔洛韦对小儿病毒性肺炎的疗效。方法：随机将符合标准的病例分为治疗组28例和对照组28例，治疗组用更昔洛韦，对照组用利巴韦林注射液，其他治疗方法相同。结果：更昔洛韦组有效率显著高于利巴韦林组。结论：更昔洛韦是一种疗效好、安全性高的抗病毒药物。     

更昔洛韦加思美泰治疗巨细胞病毒感染引起的婴儿淤胆型肝炎疗效观察

目的:探讨更昔洛韦加思美泰治疗巨细胞病毒(CMV)感染引起的婴儿淤胆型肝炎临床疗效及其副作用。方法:将2001年2月~2004年8月期间通过检测血清CMV-IgM抗体、CMV-DNA及肝功能确诊的60例CMV感染引起的淤胆型肝炎活患儿,随机分为更昔洛韦加思美泰治疗组、更昔洛韦治疗组和综合治疗组,均常规给予保肝、退黄和维生素K1治疗。结果:更昔洛韦加思美泰治疗组在降低血清丙氨酸转氨酶(sALT)、血清谷氨酰转肽酶(γ-GT)、血清总胆红素(TB)、直接胆红素及肝脏回缩方面与更昔洛韦治疗组比较有显著性差异(P<0.05),两组与综合治疗组比较亦有显著性差异(P<0.05)。结论:更昔洛韦加思美泰是目前治疗CMV感染引起的婴儿淤胆型肝炎较理想的药物,且未发现有明显的副作用。     

Progrediente Zytomegalie-Enzephalitis unter erfolgreicher Ganciclovir-Therapie einer Zytomegalie-Retinitis bei einem AIDS-Patienten

Summary We describe a case of an HIV-infected intravenous drug-abuser who died of progressive cytomegalovirus encephalitis despite successful treatment of cytomegalovirus retinitis with ganciclovir. On autopsy, complete remission of retinitis and widespread cytomegalovirus-encephalitis could be demonstrated. Therapeutic failure therefore seems attributable to insufficient CNS-distribution of ganciclovir rather than to ganciclovir-resistant cytomegalovirus strains.

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Abkürzungen CCT Craniales Computertomogramm - MRT Magnet-Resonanz-Tomogramm - CMV Zytomegalie-Virus - KBR Komplement-Bindungs-Reaktion     

更昔洛韦治疗婴儿巨细胞病毒性肝炎疗效观察

目的　探讨更昔洛韦对婴儿巨细胞病毒 (CMV)性肝炎的疗效及副作用。方法　 2 0 0 3年 1月至 2 0 0 4年 4月重庆医大儿童医院通过检测血抗CMV IgG、IgM ,血CMV DNA及肝功能检测而确定 4 0例婴儿CMV肝炎 ,随机分为更昔洛韦治疗组和综合治疗组两组 ,均常规给予保肝治疗 ,退黄 ,补充维生素处理 ,更昔洛韦治疗组加用更昔洛韦。结果　更昔洛韦治疗可使血CMV DNA阴转约 5 0 % ,在降低转氨酶、肝脏回缩、黄疸消退方面与综合治疗组比较有显著性差异 (P <0 0 5 ) ;更昔洛韦治疗组中出现白细胞下降及血小板降低的比例分别为 4 0 %、30 %。结论　更昔洛韦治疗巨细胞病毒性肝炎疗效好 ,为一较理想药物 ,但要注意该药对白细胞和血小板的影响     

更昔洛韦的小肠吸收与P-糖蛋白药泵作用的关系研究

目的:研究更昔洛韦的小肠吸收与P-糖蛋白(P-glycoprotein,P-gp)之间的关系。方法:采用外翻肠囊吸收试验和原位小肠吸收试验,分别建立了HPLC法测定肠液样本和血浆样本中更昔洛韦的浓度,以阿昔洛韦为内标,紫外检测波长为254nm,检测限分别是0.1μg·ml-1和0.06μg·ml-1。结果:普罗帕酮能提高更昔洛韦的透膜和吸收。逆转剂普罗帕酮和维拉帕米对更昔洛韦的小肠吸收都有显著的影响,都能提高更昔洛韦的血药浓度。结论:更昔洛韦是P-gp的底物,普罗帕酮具有明显的逆转P-gp药泵功能的作用。     

更昔洛韦治疗小儿巨细胞病毒性肝炎疗效观察

目的: 观察更昔洛韦治疗小儿巨细胞病毒(CMV)肝炎的疗效.方法: 36例CMV肝炎患者分为更昔洛韦治疗组20例及利巴韦林对照组16例进行比较.结果: 治疗组总有效率为 85.00%,明显高于对照组43.75%(P＜0.01).治疗组和对照组血 CMV-IgM转阴率分别为 90.00%和 50.00%;尿CMV-DNA转阴率分别为 80.00%, 25.00%.结论: 更昔洛韦是治疗小儿 CMV肝炎的有效药物.     

更昔洛韦联合丙种球蛋白对单纯疱疹病毒性脑炎患儿炎性因子与神经相关蛋白表达的影响

目的 观察更昔洛韦联合丙种球蛋白对单纯疱疹病毒性脑炎患儿炎性因子与神经相关蛋白表达水平的影响,以揭示其作用机制.方法 采用随机数字表法将西安市儿童医院2014年1月至2019年12月收治的174例单纯疱疹病毒性脑炎患儿分为对照组87例和研究组87例.对照组采用更昔洛韦治疗,研究组采用更昔洛韦联合丙种球蛋白治疗.观察两组...     

Successful treatment of cytomegalovirus encephalitis in a patient with Hodgkin's disease in remission

 Cytomegalovirus encephalitis is a rare but life-threatening infection in non-AIDS patients. To our knowledge, no case that followed conventional treatment for Hodgkin's lymphoma has been reported. We present a patient with Hodgkin's disease in complete remission after combined modality treatment who was succesfully treated with a combination of ganciclovir and foscarnet. Received: 3 September 1997 / Accepted: 3 February 1998     

Is the incidence of cytomegalovirus disease following heart transplantation decreased by prophylactic ganciclovir and CMV-hyperimmunglobulin?

Abstract Ganciclovir (DHPG) was used for the prophylaxis of CMV disease after heart transplantation (HTx) in 20 patients (aged 52 ± 8 years old). DHPG was used during the first 2 weeks post HTx, and during antirejection therapy with OKT3 or thymoglobulin (ATG), at a dosage of 3 mg/kgq 12 h in the case of a CMV + donor (D) and/or CMV — recipient (R). CMV-hyperimmunglobulin (—Ig, 1 ml/kg per week for 6 weeks) was added in the case of a CMV + donor. A historical control group included 18 HTx patients (aged 53 k 10 years old). We excluded the combination of CMV- donor and CMV-recipient. Both groups received the same immunosuppression with methylprednisolone (MP), azathio-prine, ATG, and cyclosporine A. The global incidence of CMV disease was 15% (3/20 patients) in the study group and 11% (2/18 patients) in the control group. Similar results were observed in the D +/R - combination (study group 40%, 2/5 patients; control group, 25%, 2y8 patients) and in cases of R + irrespective of D status (study group, 7%, 1/15 patients; control group 0%, 0y10 patients). No difference was observed in both groups with respect to the incidence of CMV disease after antirejection therapy either with MP or with OKT3/ATG. At 1 year post HTx, no difference was found in the incidence of acute rejection, coronary artery disease or other etiology of infection or mortality. All patients CMV disease responded to a 14-day course of DHPG (5 mg/kgq 12 h). No relapsing disease was observed, and no patient died from CMV. Our results suggested that at the doses and time-cale used, DHPF, with or without CMV-Ig did not reduce the incidence of CMV disease after HTx.     

Pharmacokinetics of ganciclovir in pediatric renal transplant recipients

Ganciclovir (GCV) is effective in preventing and treating cytomegalovirus (CMV) infection in solid organ transplant recipients. The aims of the present study were to determine the pharmacokinetics of GCV administered intravenously (IV) and orally (p.o.) as pre-emptive anti-CMV therapy in pediatric renal transplant recipients and to monitor trough levels and side-effects during pre-emptive therapy. Eleven pediatric renal transplant recipients (aged 11.0±3.9 years) were included. The diagnosis of CMV infection, based on two positive pp-65 CMV blood antigen tests at 1 week apart, was made at 39±12 days post renal transplantation. They received IV GCV at a dose of 5.0±0.3 mg/kg per 12 h for 15 days, followed by GCV p.o. at a dose of 46.7±8.2 mg/kg per 12 h for 3 months. Pharmacokinetics (PK) were studied at steady state and GCV plasma concentrations were measured by high-performance liquid chromatography. After IV GCV administration, PK parameters were: C₀=0.84±0.66 g/ml; C_max=11.77±2.82 g/ml; AUC_{0–12 h}=42.29±17.57 g/ml per hour; Cl=0.13±0.05 l/h per kg. After p.o. GCV administration, PK parameters were: C₀=1.08±0.68 g/ml; C_max=2.70±1.07 g/ml; AUC_{0–12 h}=18.97±9.36 g/ml per hour; Cl/F=2.97±1.42 l/h per kg. Bioavailability (F) was 4.9±1.2%. Pre-dose concentrations (C₀) measured under p.o. GCV (n=51) were 1.29±0.80 g/ml (8 C₀ values were below 0.5 µg/ml). Pp-65 CMV blood antigen tests became negative after 16±11 days of treatment. GCV was well tolerated. Because of the limited bioavailability, the recommended high doses of p.o. GCV (50 mg/kg per 12 h) were administered and were associated with trough levels over 0.5 µg/ml. In 1 patient who received an erroneously low dosage p.o., CMV resistance to GCV appeared, requiring foscarnet.