[1]汤　磊.重组干扰素α-2b治疗传染性单核细胞增多症疗效观察[J].新乡医学院学报,2018,35(7):588-591.[doi:10.7683/xxyxyxb.2018.07.010]
　TANG Lei.Effect of recombinant interferon α-2b in the treatment of infectious mononucleosis[J].Journal of Xinxiang Medical University,2018,35(7):588-591.[doi:10.7683/xxyxyxb.2018.07.010]
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重组干扰素α-2b治疗传染性单核细胞增多症疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年7
页码:
588-591
栏目:
临床研究
出版日期:
2018-07-05

文章信息/Info

Title:
Effect of recombinant interferon α-2b in the treatment of infectious mononucleosis
作者:
汤　磊
（重庆市巴南区人民医院儿科，重庆　401320）
Author(s):
TANG Lei
（Department of Pediatrics，Banan People′s Hospital of Chongqing，Chongqing 401320，China）
关键词:
传染性单核细胞增多症; 心肌酶谱; Epstein-Barr病毒; 重组干扰素α-2b
Keywords:
infectious mononucleosis; myocardial enzyme spectrum; Epstein-Barr virus; recombinant interferon α-2b
分类号:
R725.1
DOI:
10.7683/xxyxyxb.2018.07.010
文献标志码:
A
摘要:
目的　探讨重组干扰素α-2b治疗传染性单核细胞增多症（IM）的临床效果。方法　选择2013年11月至2017年6月重庆市巴南区人民医院收治的IM患儿174例，根据治疗方法分为观察组和对照组，每组87例。2组患儿均给予常规对症治疗，包括退热、保肝、营养心肌等治疗。在常规对症治疗基础上，对照组患儿给予更昔洛韦治疗，观察组患儿在对照组治疗基础上给予重组干扰素α-2b 治疗，连续治疗7 d。分别于治疗前和治疗后采用流式细胞术检测2组患儿外周血T淋巴细胞亚群分布，采用速率法检测2组患儿乳酸脱氢酶（LDH）、天门冬氨酸转氨酶（AST）、肌酸激酶（CK）及肌酸激酶同工酶（CK-MB）水平；采用荧光定量聚合酶链反应检测Epstein-Barr病毒（EBV）DNA水平，并计算EBV-DNA阳性率。治疗结束后评定临床疗效，并观察2组患儿不良反应情况。结果　2组患儿治疗前CD3+、CD4+、CD8+及CD4+/CD8+水平比较差异均无统计学意义（P>0.05）；2组患儿治疗后CD3+和CD8+水平显著低于治疗前（P<0.05），CD4+水平和CD4+/CD8+显著高于治疗前（P<0.05）；治疗后，观察组患儿CD3+和CD8+水平显著低于对照组（P<0.05），CD4+水平和CD4+/CD8+显著高于对照组（P<0.05）。2组患儿治疗前血清AST、LDH、CK及CK-MB水平比较差异均无统计学意义（P>0.05），2组患儿治疗后血清AST、LDH、CK及CK-MB水平显著低于治疗前（P<0.05），治疗后观察组患儿血清AST、LDH、CK及CK-MB水平显著低于对照组（P<0.05）。治疗前观察组和对照组患儿EBV-DNA阳性率分别为97.70%（85/87）、98.85%（86/87），治疗后分别为4.60%（4/87）、16.09%（14/87）；治疗前2组患儿EBV-DNA阳性率比较差异无统计学意义（χ2=0.339，P>0.05），治疗后观察组患儿EBV-DNA阳性率显著低于对照组（χ2=6.197，P<0.05）。观察组和对照组患儿治疗总有效率分别为97.70%（85/87）、86.21%（75/87），观察组患儿治疗总有效率高于对照组（χ2=4.755，P<0.05）。观察组和对照组患儿不良反应发生率分别为4.60%（4/87）、3.45%（3/87），2组患儿不良反应发生率比较差异无统计学意义（χ2=0.691，P>0.05）。结论　重组干扰素α-2b能够显著提高IM患儿的免疫功能，改善患儿的心肌酶谱，有效抑制EBV复制。
Abstract:
Objective　To investigate the clinical effect of recombinant interferon α-2b in the treatment of infectious mononucleosis （IM）.Methods　A total of 174 children with IM were selected from November 2013 to June 2017 in Banan People′s Hospital of Chongqing as the research subjects.The children were divided into observation group and control group according to the treatment method，with 87 cases in each group.The children in the two groups of children were treated with conventional symptomatic treatment，including antipyretic，liver protection，nutritive myocardium and so on.The children in the control group were treated with ganciclovir on the basis of routine symptomatic treatment，and the children in the observation group were treated with recombinant interferon α-2b on the basis of the treatment of the control group，and the treatment lasted for seven days.The distribution of T lymphocyte subsets in the peripheral blood was detected by flow cytometry；the levels of lactate dehydrogenase （LDH），aspartate aminotransferase （AST），creatine kinase （CK） and creatine kinase isoenzyme （CK-MB） were detected by enzyme rate method in the two groups before and after treatment.The level of Epstein-Barr virus （EBV） DNA was detected by fluorescence quantitative polymerase chain reaction，and the positive rate of EBV-DNA was calculated.The clinical effect was evaluated after treatment，and the adverse reactions were observed in the two groups.Results　There was no significant difference in the levels of CD3+，CD4+，CD8+ and CD4+/CD8+ between the two groups before treatment （P>0.05）.The levels of CD3+ and CD8+ after treatment were significantly lower than those before treatment （P<0.05），and the levels of CD4+ level and CD4+/CD8+ after treatment were significantly higher than those before treatment in the two groups （P<0.05）.The levels of CD3+ and CD8+ in the observation group were significantly lower than those in the control group （P<0.05），and the levels of CD4+ and CD4+/CD8+ were significantly higher than those in the control group after treatment （P<0.05）.There was no significant difference in the serum AST，LDH，CK and CK-MB levels between the two groups before treatment （P>0.05）.The levels of serum AST，LDH，CK and CK-MB after treatment were significantly lower than those before treatment in the two groups （P<0.05）.The levels of serum AST，LDH，CK and CK-MB in the observation group were significantly lower than those in the control group after treatment （P<0.05）.The positive rate of EBV-DNA in the observation group and the control group was 97.70% （85/87） and 98.85% （86/87） respectively before treatment，and it was 4.60%（4/87） and 16.09%（14/87） respectively after treatment.There was no significant difference in the positive rate of EBV-DNA between the two groups before treatment （χ2=0.339，P>0.05）.The positive rate of EBV-DNA in the observation group was significantly lower than that in the control group after treatment （χ2=6.197，P<0.05）.The total effective rate in the observation group and the control group was 97.70% （85/87） and 86.21% （75/87） respectively，the total effective rate in the observation group was higher than that in the control group （χ2=4.755，P<0.05）.The incidence of adverse reactions in the observation group and the control group was 4.60% （4/87） and 3.45% （3/87） respectively，there was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.691，P>0.05）.Conclusion　Recombinant interferon α-2b can significantly improve the immune function and the myocardial enzyme spectrum，and effectively inhibit EBV replication in IM children.

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更新日期/Last Update: 2018-07-05