脾氨肽联合还原型谷胱甘肽改善巨细胞病毒肝炎患儿肝功能损害及免疫功能的临床疗效
| 作者: |
1董雪婷,
1杨辉,
1吴艳玲,
1吴润秋,
1金玉
1 南京医科大学附属儿童医院消化科，南京 210008 |
| 通讯: |
杨辉
Email: xinghui7325@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.08.007 |
摘要
目的：评价脾氨肽联合还原型谷胱甘肽(glutathione，GSH)在巨细胞病毒(cytomegalovirus，CMV)肝炎治疗中的临床疗效。方法：纳入2018年1月至2019年1月在南京医科大学附属儿童医院消化科住院的临床诊断CMV肝炎并给予脾氨肽联合GSH治疗的患儿51例为研究对象(观察组)，根据黄疸的有无分为黄疸组(25例)和无黄疸组(26例)，其中男28例，女23例，年龄(4.82±4.16)个月。选取同期同一年龄段单用GSH治疗的CMV肝炎患儿50例作为对照组，包括黄疸组26例，无黄疸组24例，男27例，女23例，年龄(5.75±3.09)个月，于治疗前1 d、治疗后14，28 d，检测患儿肝功能、细胞免疫水平及CMV抗体滴度及DNA负载值，对比分析脾氨肽联合GSH治疗和单用GSH治疗在CMV肝炎治疗中的临床疗效。结果：黄疸型CMV肝炎患儿的治疗，观察组治疗后28 d谷丙转氨酶(ALT)、总胆红素水平均较对照组显著下降；观察组治疗后14 d直接胆红素、γ-谷氨酰转肽酶水平也较对照组明显减轻。无黄疸型CMV肝炎患儿的治疗，观察组治疗后28 d ALT水平均较对照组显著下降。CMV肝炎(包括黄疸型和无黄疸型)患儿，观察组治疗28 d，外周血CD4+细胞数量显著高于对照组。此外，观察组临床总有效率高于对照组。结论：脾氨肽联合GSH治疗可显著改善CMV肝炎患儿肝功能损害，增强免疫功能，临床总疗效优于单用GSH。
关键词：
巨细胞病毒肝炎；脾氨肽；还原型谷胱甘肽；肝功能损害；免疫功能
Clinical efficacy of splenic aminopeptide combined with GSH in improving hepatic damage and immune function in children with cytomegalovirus hepatitis
CorrespondingAuthor: YANG Hui Email: xinghui7325@sina.com
DOI: 10.3978/j.issn.2095-6959.2019.08.007
Abstract
Objective: To evaluate the clinical efficacy of splenic aminopeptide combined with GSH in the treatment of CMV hepatitis. Methods: From January 2018 to January 2019, 51 children with CMV hepatitis who were hospitalized in the Department of Gastroenterology, Children’s Hospital of Nanjing Medical University were divided into a jaundice group (25 cases) and a non-jaundice group (26 cases), including 28 males and 23 females, aged (4.82±4.16) months. Fifty children with CMV hepatitis treated with GSH alone in the same age group were selected as a control group, including 26 cases in a jaundice group, 24 cases in a non-jaundice group, 27 males and 23 females, aged (5.75±3.09) months. Liver function, cellular immunity level, CMV antibody titer and DNA load were measured at 1 day before the treatment, 14 days and 28 days after the treatment. The clinical effect of splenic ammonia peptide combined with GSH and single GSH treatment in CMV hepatitis were compared and analyzed. Results: The levels of ALT and total bilirubin in the observation group were significantly lower than those in the control group at 28 days after the treatment, and the levels of direct bilirubin and γ-glutamyltransferase in the observation group were significantly lower than those in the control group at 14 days after the treatment. The level of ALT in the observation group was significantly lower than that in the control group after 28 days of treatment for children with CMV hepatitis without jaundice. The number of CD4+ cells in peripheral blood of children with CMV hepatitis (including jaundice type and non-jaundice type) was significantly higher in the observation group than in the control group 28 days after the treatment. In addition, the total clinical effective rate in the observation group was higher than that in the control group. Conclusion: Splenic aminopeptide combined with GSH can significantly improve liver function damage and enhance immune function in children with CMV hepatitis. The total clinical efficacy is better than that of GSH alone.
Keywords：
cytomegalovirus hepatitis; splenic aminopeptide; reduced glutathione; hepatic damage; immune function