更昔洛韦治疗小儿病毒性脑炎临床疗效分析

目的:探讨更昔洛韦治疗小儿病毒性脑炎的临床效果。方法:105例病毒性脑炎患儿被随机分为试验组(n=54)和对照组(n=51),两组均给予常规综合治疗,对照组加用病毒唑治疗,试验组加用更昔洛韦治疗。结果:试验组总有效率为98.1%,痊愈率为94.4%;对照组总有效率为86.3%,痊愈率为74.5%。试验组临床效果显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论:更昔洛韦结合常综合治疗应用于病毒性脑炎的治疗,能显著提高临床效果,改善患者生活质量,值得在临床上应用和推广。     

龙胆泻肝汤结合更昔洛韦眼用凝胶治疗流行性角结膜炎疗效观察

[目的]观察中药结合更昔洛韦眼用凝胶治疗流行性角结膜炎的,临床疗效。[方法]将42例（84只眼）流行性角结膜炎患者分为治疗组22例（44只眼）和对照组20例（40只眼）。治疗组采用中药内服并予超声雾化熏眼,局部滴更昔洛韦胶4次／d,对照组单纯用西药0．1％无环鸟苷眼液、0．3％泰利必妥眼液治疗．5～6次／d。[结果]治疗组总有效率为100％,对照组总有效率为80％,差异有统计学意义。[结论]中西医结合治疗流行性角结膜炎有更显著效果。     

Late-onset CMV disease following CMV prophylaxis

Background  Cytomegalovirus (CMV) is the most common opportunistic infection after solid-organ transplantation, increasing morbidity and mortality. Three months of oral valganciclovir have been shown to provide effective prophylaxis. Late-onset CMV disease, occurring after the discontinuation of prophylaxis, is now increasingly recognised. Aims  To investigate the incidence and the time of detection of CMV infections in liver transplant recipients who received CMV prophylaxis. Methods  Retrospective review of 64 high- and moderate-risk patients with 1 year of follow-up. Results  The incidence of CMV infection was 12.5%, with 4.7% disease. All cases of symptomatic CMV disease were of late-onset. Conclusions  The incidence of CMV infections in this study was low compared with literature reports; however, the late-onset disease is an emerging problem. Detection of late-onset disease may be delayed because of less frequent clinic follow-up visits. Increased regular laboratory monitoring may allow earlier detection at the asymptomatic infection stage. This research was undertaken as part of an MSc in Hospital Pharmacy, awarded by Trinity College Dublin.     

阿昔洛韦与更昔洛韦治疗成人水痘的疗效比较

目的:比较阿昔洛韦与更昔洛韦治疗成人水痘的疗效。方法:将我院140例水痘患者,按住院单双日随机均分为阿昔洛韦组与更昔洛韦组,分别给予阿昔洛韦与更昔洛韦10mg.kg-1,bid,静脉滴注。观察并记录2组患者的退热时间、皮疹结痂时间、总有效率和不良反应。结果:更昔洛韦组患者的退热时间明显短于阿昔洛韦组,2组比较差异有统计学意义(P<0.05);2组的皮疹结痂时间比较,差异无统计学意义(P>0.05);更昔洛韦组的总有效率明显高于阿昔洛韦组(P<0.05)。2组治疗过程中,均未见不良反应发生。结论:更昔洛韦治疗成人水痘的疗效显著优于阿昔洛韦,且退热时间短于阿昔洛韦。     

静脉注射更昔洛韦联合局部液氮冷冻治疗尖锐湿疣的疗效观察

目的：观察静脉注射更昔洛韦联合液氮冷冻术对尖锐湿疣的疗效。方法：把62例尖锐湿疣患者随机分为观察组和对照组,观察组采用静脉注射更昔洛韦联合冷冻术,对照组采取单一的冷冻术,随访3个月。结果：观察组痊愈率及总有效率分别为59.38%和87.5%,与对照组比较均有显著性差异（P〈0.01及P〈0.05）。结论：静脉注射更昔洛韦联合液氮冷冻术比单一的液氮冷冻术对尖锐湿疣具有更好的疗效。     

α-干扰素和更昔洛韦治疗传染性单核细胞增多症的疗效比较

目的比较α-干扰素（α-INF）和更昔洛韦（GCV）治疗儿童传染性单核细胞增多症（IM）的疗效。方法222例儿童IM分为GCV治疗组（59例）、α-INF治疗组（74例）和其他药物（利巴韦林等）治疗组（89例）,3组患儿年龄、性别、病程、病情等无明显差异。GCV治疗组给以GCV10mg/（kg.d）,1次/12h,静脉滴注,7d后改为5mg/（kg.d）,1次/d,静脉滴注,总疗程10～14d。α-INF治疗组给以α-INF5万U/（kg.d）,肌内注射,总疗程10～14d。结果GCV治疗组和α-INF治疗组在热程、咽峡炎改善、淋巴结、肝脾开始缩小、异型淋巴细胞恢复至〈10%的时间等方面均优于其他药物治疗组,差异有显著性;而该两组之间上述各项指标改善的比较无统计学差异;②GCV治疗组4例出现粒细胞降低,α-INF治疗组11例出现发热,均在停药后3～7d恢复正常。结论应用GCV及α-INF治疗IM均可取得明显疗效,GCV与α-INF之间的疗效比较并无明显差别,两种药物均无严重不良反应。     

对血浆HCMV-IgM、尿HCMV-DNA阳性患儿用更昔洛韦干预意义

目的：调查对巨细胞病毒感染婴儿用更昔洛韦治疗的必要性。方法：本研究对2007年10月～2008年10月在深圳市宝安区妇幼保健院住院的0～6个月龄婴儿2840例,以ELISA法及PCR技术对患儿血浆HCMV—IgM、患儿尿及其母乳汁HCMV—DNA进行了检测,并对结果阳性及有临床症状的患儿分治疗组及对照组。治疗组采用更昔洛韦为主的综合治疗,对照组主要采取对症治疗,并判断疗效。结果：2840例患婴中血浆HCMV—IgM阳性者184例,占6．478％,尿HCMV—DNA升高者180例,占血浆HCMV—IgM阳性者97．8％,其母乳汁HCMV—DNA升高者170例,占血浆HCMV—IgM阳性者92．4％,对血清HCMV—IgM阳性、尿及其母乳汁HCMV—DNA升高的患儿分治疗组45例及对照组125例,发现治疗组临床症状改善42例（占93．3％）,尿HCMV—DNA滴度降低30例（占66．7％）,血浆HCMV—IgM转阴22例（占48．9％）。对照组临床症状改善80例（占64％）,尿HCMV—DNA滴度降低10例（占8％1,血浆HCMV—IgM转阴2例（占1．6％）。结论：采用更昔洛韦为主的综合治疗与采取单纯对症治疗相比。差异具有统计学意义,P〈0．01。     

Cytomegalovirus enteritis in immunocompetent subjects: A case report and review of the literature

Cytomegalovirus (CMV) enteritis (or colitis) is generally diagnosed in immunocompromised patients in association with human immunodeficiency virus infection as well as in recipients of solid organ or hematopoietic stem cell transplant. CMV enteritis has been reported only sporadically in immunocompetent individuals. We encountered a 76-year-old woman who developed CMV enteritis without any previously identified immunocompromised states. An extensive literature review of 33 cases of CMV enteritis or colitis diagnosed in immunocompetent individuals, including the present case, revealed that the median age of the patients was 68, the accompanying symptoms were diarrhea (76%), abdominal pain (52%), and hematochezia or melena (27%), and that the outcome was generally favorable, including resolution without any treatment in 24% of the patients. CMV enteritis should be recognized more widely as a disease entity not only in immunocompromised patients but also in immunocompetent individuals, especially in elderly populations.     

丙种球蛋白联合更昔洛韦对呼吸道合胞病毒肺炎患儿肺功能影响

目的：探讨丙种球蛋白联合更昔洛韦对呼吸道合胞病毒（RSV）肺炎患儿肺功能的影响。方法：将87例RSV肺炎患儿随机分为两组,对照组43例给予更昔洛韦治疗,5mg·kg-1次-1,2次／d;观察组44例在对照组治疗基础上,加用丙种球蛋白治疗,400mg·kg-1次-1,1次／d,持续治疗14d;检测治疗前、后呼吸频率（RR）、潮气量（VT／kg）、达峰容积比（VPTEF／VE）、达峰时间比（TPTEF／TE）等肺功能指标变化。结果：观察组治疗总有效率高于对照组,差异具有统计学意义（P〈0．05）;治疗后观察组RR低于对照组,差异具有统计学意义（P〈0．05）;治疗后观察组TPTEF／TE及VPTEF／VE高于对照组,差异具有统计学意义（P〈0．05）。结论：更昔洛韦可有效抗病毒,丙种球蛋白可增强RSV肺炎患儿免疫力,促进炎症消除,两者合用可改善患儿肺功能,值得临床推广应用。     

Pharmacokinetics of ganciclovir in renal transplant children

Three cytomegalovirus (CMV)-seronegative children received renal transplants from CMV-seropositive donors and developed clinical symptoms of CMV infection between days 20 and 34 post transplantation. Ganciclovir (DHPG) was administered in a 1-h infusion, and the doses and dose intervals were adapted to the degree of renal insufficiency, according to the manufacturer's recommendations for adults. Individual pharmacokinetic parameters of DHPG were determined and were markedly altered. Plasma clearances were 0.4, 1.1 and 2.2 ml/min per kg and were related to individual creatinine clearances (20, 45 and 60 ml/min per 1.73 m²); the corresponding elimination half-lives were 23.7, 9.9 and 3.9 h. In two patients, the doses had to be further reduced in order to maintain plasma levels within the recommended values for peak and trough plasma concentrations. Therefore, monitoring of DHPG appears essential in adjusting dosage for optimal efficacy and minimal toxicity.