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目的 分析婴儿巨细胞病毒 (CMV)肝炎的临床特征及更昔洛韦的治疗效果。方法 回顾性分析 5 0例婴儿 CMV肝炎的临床特征。1999年 1月至 2 0 0 0年 12月住院的 30例患儿单纯用保肝退黄治疗 14天 ;2 0 0 1年 1月至 2 0 0 2年 12月住院的 2 0例患儿除保肝退黄治疗外加用更昔洛韦诱导抗病毒治疗 ;分别对比两组治疗前后血清总胆红素和肝酶 (AL T、γ- GT、 AKP)水平及肝脾大小的变化 ,同时观察更昔洛韦的不良反应。结果 婴儿 CMV肝炎大部分以黄疸为首发表现就诊 ,但也有以其它系统损害症状就诊者。先天性感染者易合并先天畸形 ,可导致胆道梗阻 ,预后差 ;一般的保肝退黄治疗婴儿 CMV肝炎效果差 ;加用更昔洛韦抗病毒治疗 ,血清总胆红素、 AL T、γ- GT水平下降、肝脾回缩 ,差别有显著性统计学意义 (P<0 .0 5 )。 1例患儿更昔洛韦治疗后出现粒细胞及血小板减少 ,停药后很快恢复。结论 婴儿巨细胞病毒肝炎临床表现多样 ,常合并其它系统和脏器的损害。先天性感染危害尤大 ,更昔洛韦治疗 CMV肝炎短期内较为安全有效 ,但仍需进一步观察
Objective To analyze the clinical characteristics of infant cytomegalovirus (CMV) hepatitis and the therapeutic effect of ganciclovir. Methods A retrospective analysis of 50 cases of infant CMV hepatitis clinical features. Thirty children admitted to hospital from January 1999 to December 2000 were treated for 14 days with pure liver and rehmannia; 20 children admitted to hospital from January 2001 to December 2002 In addition to liver and Huang treatment plus ganciclovir-induced antiviral therapy; respectively before and after treatment of serum total bilirubin and liver enzymes (AL T, γ-GT, AKP) levels and changes in liver and spleen size, at the same time Adverse reactions of ganciclovir were observed. Results The majority of infants with CMV hepatitis presented with jaundice as the first symptom, but other symptoms were also impaired. Congenital infection is easy to merge congenital malformation, can lead to biliary obstruction, the prognosis is poor; general liver protection Huang treatment of infantile CMV hepatitis is poor; plus ganciclovir antiviral therapy, serum total bilirubin, AL T, γ - The level of GT decreased, liver and spleen retracted, the difference was statistically significant (P <0.05). One case of ganciclovir treatment of patients with granulocytes and thrombocytopenia, withdrawal soon after recovery. Conclusion The clinical manifestations of infant cytomegalovirus are diverse, often associated with other systemic and organ damage. Congenital infection is particularly harmful, ganciclovir CMV treatment of hepatitis in the short term is more safe and effective, but still need further observation