土家药治疗单纯疱疹性角膜炎的临床研究

目的:观察土家药结合西医外治单纯疱疹性角膜炎(HSK)的临床疗效.方法:将70例(85眼)本病患者随机分为治疗组40例(50眼)和对照组30例(35眼).治疗组采用西医常规治疗结合内服土家药.对照组单纯西医常规治疗.结果:治疗8周后,治疗组治愈率为84.0%,对照组治愈率为42.8%,两组比较,治疗组疗效优于对照组(P<0.05).结论:土家药结合西医外治单纯疱疹性角膜炎可明显提高临床疗效.     

Infections aiguës à herpèsvirus humain 6 (HHV-6) : quand et comment traiter ?

The pathogenicity of human herpesvirus 6 (HHV-6) still raises numerous questions. Acute HHV-6 infections correspond to primary infections, reactivations or exogenous reinfections. The expression of related clinical symptoms is highly variable but may be extremely severe, particularly among immunocompromised patients. The prototypic severe disease associated with these infections is limbic encephalitis occurring in stem cell transplant recipients. The diagnosis of acute HHV-6 infections relies on the quantitation of viral load in whole blood by means of quantitative PCR. The demonstration of HHV-6 causative role in the genesis of clinical symptoms requires additional investigations such as the search for HHV-6 DNA in cerebrospinal fluid in case of encephalitis. The chromosomal integration of HHV-6 DNA is a rare event among HHV-6-infected subjects but may alter the interpretation of virological results. Therapy with ganciclovir, foscarnet or cidofovir has not yet clear indications but, at the current stage of knowledge, only concerns the treatment of highly symptomatic infections. The usefulness of prophylactic or pre-emptive antiviral chemotherapy has not yet been convincingly demonstrated. Treatment efficacy must be checked through a clinical and virological follow up, based in part on quantitative PCR approaches. Controlled studies are urgently needed with the goal of evaluating the cost-effectiveness of HHV-6 follow up and therapy in different clinical situations.     

窄谱中波紫外线联合更昔洛韦治疗老年带状疱疹疗效观察

目的观察窄谱中波紫外线(NB-UVB)联合更昔洛韦治疗老年带状疱疹的临床疗效。方法 60例老年带状疱疹患者随机分为观察组和对照组各30例。观察组采用NB-UVB联合更昔洛韦治疗,对照组仅予更昔洛韦治疗。观察2组临床疗效及止痛时间、止疱时间、结痂时间。结果观察组总有效率高于对照组,止痛时间、止疱时间、结痂时间均短于对照组,差异均有统计学意义(P<0.05)。结论 NB-UV联合更昔洛韦治疗老年带状疱疹取得较好的疗效,值得临床推广应用。     

小儿呼吸道感染用抗病毒药治疗的不良反应

目的观察分析应用更昔洛韦或病毒唑治疗急性上呼吸道病毒感染患儿的药物不良反应,为安全用药提供参考。方法选择2008年1月～2010年l2月间1727例急性上呼吸道病毒感染的患儿,按所用药物不同将其分为病毒唑组832例,更昔洛韦组895例。观察其接受更昔洛韦或病毒唑治疗后出现的不良反应。结果检出更昔洛韦与病毒唑的药物不良反应发生例数共159例,占9.2%,两者的不良反应发生无性别差异,无发生率差异;但不同年龄组比较,婴儿组不良反应发生率最高为18.2%。更昔洛韦不良反应主要在消化系统、血液系统,其次为变态反应;病毒唑主要是变态反应和血液系统,其次为消化系统。未见严重不良反应,预后均好。结论更昔洛韦与病毒唑的药物不良反应多样化,侵犯不同机体系统,但发生的后果及其预后相近且在临床使用中尚能被患者及医师所接受;应严密观察婴儿组的用药,严格把握适应证。     

更昔洛韦治疗小儿手足口病的疗效观察

目的:探讨更昔洛韦(GCV)对小儿手足口病(HFMD)的临床疗效。方法:选择1~6岁患手足口病患儿80例随机分为两组,治疗组给予更昔洛韦,对照组给予利巴韦林治疗,对临床症状和体征的变化进行分析。结果:治疗组临床症状和体征均较对照组消失早(P<0.01)。结论:更昔洛韦治疗小儿手足口病疗程短、见效快,有明显疗效。     

我院2008年常用抗病毒药临床应用分析

目的:了解我院2008年常用抗病毒药的应用现状,为临床合理用药提供参考。方法:采用回顾性方法,对我院2008年临床各科室住院患者病历抗病毒药及不合理用药情况进行统计、分析。结果:我院常规应用10种抗病毒药,其中利巴韦林注射液的应用率最高,达43.67%;小儿科应用抗病毒药的频率最高;不合理用药病历中无指征用药现象最严重,占56.52%。结论:我院抗病毒药品种基本固定,利巴韦林、阿昔洛韦和更昔洛韦为治疗病毒感染的临床常用药;更昔洛韦应用不合理,存在严重无指征用药,应加强监督,规范其临床应用。     

双歧三联活菌散联合更昔洛韦治疗婴儿巨细胞病毒性肝炎疗效观察

目的观察双歧三联活菌散联合更昔洛韦治疗婴儿巨细胞病毒（CMV）性肝炎的疗效。方法将65例婴儿CMV肝炎随机分成对照组30例与治疗组35例,均给予一般保肝利胆治疗,治疗组加用更昔洛韦和双歧三联活菌散治疗。比较两组总胆红索（TBIL）、结合胆红素（DBIL）、谷丙转氨酶（ALT）的变化及CMV-DNA转阴率。结果治疗组与对照组相比黄疸消退、肝功能恢复及CMV-DNA转阴率均有显著性差异（p均〈0.01）。结论双歧三联活菌散联合更昔洛韦治疗婴儿CMV肝炎疗效显著、安全,值得临床推广应用。     

更昔洛韦凝胶治疗疱疹性口炎临床疗效观察

目的:观察更昔洛韦凝胶在疱疹性口炎应用中的临床疗效.方法:160例患儿随机分为治疗组86例,对照组74例.两组均静脉给予阿昔洛韦和维生素C,治疗组局部使用更昔洛韦凝胶,对照组使用口灵含漱液.结果:治疗组总有效率(97.6%)明显高于对照组总有效率(70.2%),两组比较差异具有统计学意义(χ2=23.428,P<0.01).结论:更昔洛韦凝胶治疗疤疹性口炎疗效满意.     

Cytomegalovirus infection in severe ulcerative colitis patients undergoing continuous intravenous cyclosporine treatment in Japan

AIM： TO investigate active cytomegalovirus （CMV） infection following the cydosporine A （CyA） treatment of steroid-refractory ulcerative colitis （UC）. METHODS： Twenty-three patients with severe UC not responding to steroid therapy （male 14, and female 9） enrolled at Nagoya University Hospital from 1999 to 2005. They received continuous intravenous infusion of CyA （average 4 mg/kg per day） for 1 mo. Serum and colonic biopsy samples were collected before CyA treatment and 4 d, 10 d, 20 d, and 30 d after treatment. Patients were evaluated for CMV by using serology （IgM antibody by ELISA）, quantitative real-time PCR for CMV DNA, and histopathological assessment of hematoxylin and eosin （HE）-stained colonic biopsies. CMV infection was indicated by positive results in any test. RESULTS： No patients had active CMV infection before CyA treatment. Eighteen of 23 UC patients treated with CyA were infected with active CMV （IgM antibody in 16/23 patients, 69.6%; CMV DNA in 18/23 patients, 78.2%; and inclusion bodies in 4/23 patients, 17.3%）. There was no difference in the active CMV-infection rate between males and females. Active CMV infection was observed after approximately 8 d of CyA treatment, leading to an exacerbation of colitis. Fifteen of these 18 patients with active CMV infection （83.3%） required surgical treatment because of severe deteriorating colitis. Treatment with ganciclovir rendered surgery avoidable in three patients. CONCLUSION： Our results suggest that active CMV infection in severe UC patients treated with CyA is associated with poor outcome. Further, ganciclovir is useful for treatment of CMV-associated UC after immunosuppressive therapy.