CAJ | 학술논문

目的探讨单磷酸阿糖腺苷(Ara-A)治疗婴儿巨细胞病毒肝炎的疗效.方法回顾性分析2012年1月至2013年10月郑州大学第三附属医院100例巨细胞病毒肝炎患儿,按照使用的抗病毒药物分为2组:Ara-A组42例、对照组58例.Ara-A组予单磷酸Ara-A 10 mg/(kg·d),用2周停2周为1个疗程,连用2个疗程;对照组予更昔洛韦10 mg/(kg·d),分2次静脉滴注,14 d后改为5 mg/(kg·d),用1周停1周,总疗程为1.5 ～2.0个月;2组均予常规保肝、退黄等对症治疗.比较2组治疗前后肝功能变化,比较2组黄疸消退时间、转氨酶恢复正常时间、药物不良反应、病毒转阴时间、住院时间、住院花费,评价临床疗效.结果治疗2周,Ara-A组丙氨酸氨基转移酶(ALT)水平显著低于对照组,差异有统计学意义(P＜0.05);治疗2个月,Ara-A组ALT、天冬氨酸转氨酶水平均显著低于对照组,差异均有统计学意义(P均＜0.05).Ara-A组转氨酶降至正常时间[(38.5±16.7)d]较对照组[(44.3±22.9)d]显著缩短,差异有统计学意义(F=3.845,P＜0.05);Ara-A组黄疸消退时间[(27.1±10.5)d]、病毒DNA定量转阴时间[(39.5±24.0)d]、住院时间[(22.6±5.8)d]、住院花费[(10 521.9 ±2 662.3)元]与对照组相比,差异均无统计学意义(F=1.111、2.837、0.840、2.223,P均＞0.05).Ara-A组病毒DNA定量转阴率(80.9％)高于对照组(62.1％),且肝损伤发生率(7.1％)低于对照组(15.5％),差异有统计学意义(x2 =9.137、11.514,P均＜0.05).结论单磷酸Ara-A治疗婴儿巨细胞病毒肝炎的疗效肯定,不良反应低于更昔洛韦,临床值得应用.
목적 탐토단린산아당선감(Ara-A)치료영인거세포병독간염적료효.방법 회고성분석2012년1월지2013년10월정주대학제삼부속의원100례거세포병독간염환인,안조사용적항병독약물분위2조:Ara-A조42례、대조조58례.Ara-A조여단린산Ara-A 10 mg/(kg·d),용2주정2주위1개료정,련용2개료정;대조조여경석락위10 mg/(kg·d),분2차정맥적주,14 d후개위5 mg/(kg·d),용1주정1주,총료정위1.5 ～2.0개월;2조균여상규보간、퇴황등대증치료.비교2조치료전후간공능변화,비교2조황달소퇴시간、전안매회복정상시간、약물불량반응、병독전음시간、주원시간、주원화비,평개림상료효.결과 치료2주,Ara-A조병안산안기전이매(ALT)수평현저저우대조조,차이유통계학의의(P＜0.05);치료2개월,Ara-A조ALT、천동안산전안매수평균현저저우대조조,차이균유통계학의의(P균＜0.05).Ara-A조전안매강지정상시간[(38.5±16.7)d]교대조조[(44.3±22.9)d]현저축단,차이유통계학의의(F=3.845,P＜0.05);Ara-A조황달소퇴시간[(27.1±10.5)d]、병독DNA정량전음시간[(39.5±24.0)d]、주원시간[(22.6±5.8)d]、주원화비[(10 521.9 ±2 662.3)원]여대조조상비,차이균무통계학의의(F=1.111、2.837、0.840、2.223,P균＞0.05).Ara-A조병독DNA정량전음솔(80.9％)고우대조조(62.1％),차간손상발생솔(7.1％)저우대조조(15.5％),차이유통계학의의(x2 =9.137、11.514,P균＜0.05).결론 단린산Ara-A치료영인거세포병독간염적료효긍정,불량반응저우경석락위,림상치득응용.
Obgective To investigate the clinical effect of Adenine arabinoside monophosphate (Ara-A) on the treatment of infant cytomegalovirus hepatitis.Methods One hundred cases of infants with cytomegalovirus hepatitis in the Third Affiliated Hospital of Zhengzhou University from January 2012 to October 2013 were included and divided into 2 groups:Am-A group treated with Ara-A [a course of treatment lasting for 2 months included 10 mg/(kg · d) for first 2 weeks followed by 2 weeks' interval,and then resumed],and then control group was given ganciclovir [10 mg/(kg · d) for 14 days and 5 mg/(kg · d) for 1 week after 1 week's interval,for a total treatment period of 1.5 to 2.0 months].Both groups were given conventional therapy.Both before and after treatment,liver function,time of jaundice and transaminase back to normal,quantification of viral DNA returns to negative,side effects,hospitalization time and cost were also compared.Results After 2 weeks,alanine aminotramferase(ALT) in Ara-A group was significantly lower than that of the control group,and there was significant difference (P ＜0.05).After 2 months,ALT,aspartate transaminase in Ara-A group were significantly lower than those in the control group (all P ＜ 0.05).Time of transaminase back to normal [(38.5 ± 16.7) d] was significantly reduced compared with the control group [(44.3 ±22.9) d] (F =3.845,P ＜ 0.05).Time of jaundice back to normal [(27.1 ± 10.5) d],quantification of viral DNA back to negative [(39.5 ±24.0) d],hospitalization time [(22.6 ±5.8) d] and costs [(10 521.9 ±2 662.3) yuan] in Ara-A group had no significant difference compared with those of the control group (F =1.111,2.837,0.840,2.223,all P ＞ 0.05).The negative rate of viral DNA quantification in Ara-A group (80.9％) was higher than that of the control group (62.1％),and the liver injury rate (7.1％) was lower than that of the control group (15.5％),and the difference was statistically significant (x2 =9.137,11.514,all P ＜ 0.05).Condusion Ara-A is safe and effective for infant cytomegalovirus hepatitis and it is suitable for the clinical practice.