异甘草酸镁对无黄疸型巨细胞病毒肝炎患儿肝功能、T淋巴细胞亚群及CMV-DNA的影响

王红; 郭岸英

doi:10.16766/j.cnki.issn.1674-4152.002506

异甘草酸镁对无黄疸型巨细胞病毒肝炎患儿肝功能、T淋巴细胞亚群及CMV-DNA的影响

doi: 10.16766/j.cnki.issn.1674-4152.002506

王红^1, ,,
郭岸英²

1.
宁波市妇女儿童医院儿童消化科, 浙江宁波 315010
2.
宁波市妇女儿童医院妇幼综合办公室

基金项目:

浙江省卫生健康科技计划项目 2021KY1059

详细信息

通讯作者:
王红, E-mail: lkwhong@163.com

中图分类号: R512.6 R725.7
计量
- 文章访问数: 183
- HTML全文浏览量: 55
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2021-05-06
- 网络出版日期: 2022-09-21

Effects of magnesium isoglycyrrhizinate on liver function, T lymphocyte subset and CMV-DNA in infants with anicteric cytomegalovirus hepatitis

WANG Hong^{1
, ,},
GUO An-ying²

1.
Department of Pediatrics Gastroenterology, Ningbo Women and Children ' s Hospital, Ningbo, Zhejiang 315010, China

摘要

摘要: 目的研究异甘草酸镁注射液对无黄疸型巨细胞病毒肝炎患儿肝功能、T淋巴细胞亚群及巨细胞病毒DNA (CMV-DNA)的影响。方法选取宁波市妇女儿童医院儿童消化科2017年8月-2020年6月间收治的无黄疸型巨细胞病毒(CMV)肝炎患儿60例, 采用随机数字法将其分为对照组和观察组, 每组30例。对照组患儿静滴还原型谷胱甘肽注射液治疗, 观察组患儿予异甘草酸镁注射液治疗, 均连续治疗2周。比较2组患儿治疗前后肝功能指标、T淋巴细胞亚群及CMV-DNA拷贝数, 同时比较2组患儿不良反应发生率。结果治疗后, 观察组外周血ALT、AST及碱性磷酸酶(ALP)水平均明显低于对照组[(48.05±12.53) U/L vs.(72.34±20.60) U/L、(46.90±16.54) U/L vs.(81.35±22.36) U/L、(51.67±13.85) U/L vs.(80.21±16.39) U/L, t=5.518、6.784、7.285, 均P < 0.001], CD3⁺和CD8⁺均明显低于对照组(均P < 0.001), CD4⁺和CD4⁺/CD8⁺均明显高于对照组(均P < 0.001), CMV-DNA拷贝数明显低于对照组(P < 0.001);2组患儿的不良反应发生率分别为20.00%、13.33%, 差异无统计学意义(P=0.488)。结论异甘草酸镁对无黄疸型CMV肝炎患儿的临床疗效显著, 能改善机体免疫功能, 促进患儿肝功能恢复, 且治疗不良反应少。
- 异甘草酸镁 /
- 巨细胞病毒感染 /
- 肝炎 /
- 肝功能 /
- T淋巴细胞亚群
Abstract: Objective To study the effect of magnesium isoglycyrrhizinate injection on liver function, T lymphocyte subsets and CMV-DNA in infants with anicteric cytomegalovirus (CMV) hepatitis. Methods A total of 60 infants with anicteric CMV hepatitis admitted to Ningbo Women and Children's Hospital from August 2017 to June 2020 were randomly divided into control group (n=30) and observation group (n=30).The control group was treated with reduced glutathione injection, whereas the observation group was treated with magnesium isoglycyrrhizinate injection for 2 weeks.The indexes of liver function, T lymphocyte subsets and CMV-DNA copies before and after treatment were compared between the two groups.The incidence of adverse reactions was also compared between the two groups. Results After treatment, the levels of ALT, AST and ALP in the observation group were significantly lower than those in the control group[(48.05±12.53) U/L vs.(72.34±20.60) U/L, (46.90±16.54) U/L vs.(81.35±22.36) U/L, (51.67±13.85) U/L vs.(80.21±16.39) U/L, t=5.518, 6.784, 7.285, all P < 0.001].The CD3⁺ and CD8⁺ levels were significantly lower in the observation group than those in the control group (all P < 0.001).The CD4⁺ and CD4⁺/CD8⁺ levels were significantly higher in the observation group than those in the control group (all P < 0.001).The copy number of CMV-DNA was significantly lower in the observation group than that in the control group (P < 0.001).The incidence of adverse reactions in the two groups were 20.00% and 13.33% respectively, with no significant difference (P=0.488). Conclusion Magnesium isoglycyrrhizinate is effective in the treatment of anicteric CMV hepatitis in infants, which can improve immune function and promote the recovery of liver function with less adverse reaction.
- Magnesium isoglycyrrhizinate /
- Cytomegalovirus infection /
- Hepatitis /
- Liver function /
- T lymphocyte subsets

HTML全文

表 1 2组无黄疸型巨细胞病毒感染肝功能损害患儿治疗前后肝功能指标比较(x ±s，U/L)

Table 1. 2 Comparison of liver function indexes before and after treatment in children with liver function damage caused by non-icteric cytomegalovirus infection (x ±s, U/L)

组别	例数	ALT		AST		ALP
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	30	165.92±32.41	72.34±20.60^a	186.27±50.86	81.35±22.36^a	156.42±41.38	80.21±16.39^a
观察组	30	173.21±38.73	48.05±12.53^a	178.93±51.24	46.90±16.54^a	158.20±41.27	51.67±13.85^a
t值		0.791	5.518	0.557	6.784	0.168	7.285
P值		0.432	< 0.001	0.580	< 0.001	0.868	< 0.001
注：与同组治疗前比较，^aP＜0.05。

下载: 导出CSV

表 2 2组无黄疸型巨细胞病毒感染肝功能损害患儿治疗前后T淋巴细胞亚群比较(x ±s)

Table 2. Comparison of T lymphocyte subsets before and after treatment in 2 groups of children with liver function damage caused by non-icteric cytomegalovirus infection (x ±s)

组别	例数	CD3⁺(%)		CD4⁺(%)		CD8⁺(%)		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	30	81.68±7.41	68.12±5.94^a	24.39±4.81	29.67±5.41^a	35.78±7.25	31.86±6.74^a	0.72±0.24	0.85±0.21^a
观察组	30	82.30±7.45	52.33±5.61^a	23.87±5.06	37.26±5.53^a	35.74±7.36	24.91±6.03^a	0.70±0.18	1.26±0.23^a
t值		0.323	10.585	0.408	5.374	0.021	4.209	0.365	7.210
P值		0.748	< 0.001	0.685	< 0.001	0.983	< 0.001	0.716	< 0.001
注：与同组治疗前比较，^aP＜0.05。

下载: 导出CSV

表 3 2组无黄疸型巨细胞病毒感染肝功能损害患儿治疗前后血CMV-DNA拷贝数比较(x ±s，copies/mL)

Table 3. Comparison of blood CMV-DNA copy number before and after treatment between two groups of children with liver function damage caused by non-icteric cytomegalovirus infection (x ±s, copies/mL)

组别	例数	治疗前	治疗后^a
对照组	30	(19.23±2.86)×10³	(10.87±1.63)×10³
观察组	30	(20.14±2.79)×10³	(3.62±0.67)×10³
t值		1.247	22.533
P值		0.217	< 0.001
注：同组治疗后与治疗前比较，^aP＜0.05。

下载: 导出CSV

表 4 2组无黄疸型巨细胞病毒感染肝功能损害患儿不良反应发生率比较

Table 4. Comparison of the incidence of adverse reactions in non-icteric cytomegalovirus infected children with liver function damage between two groups

组别	例数	呕吐[例(%)]	纳差[例(%)]	皮疹[例(%)]	总发生率(%)
对照组	30	1(3.33)	4(13.33)	1(3.33)	20.00(6/30)
观察组	30	0	3(10.00)	1(3.33)	13.33(4/30)
注：2组不良反应发生率比较，χ²=0.480，P=0.488。

下载: 导出CSV

参考文献(15)

[1]	中华医学会儿科学分会感染学组, 全国儿科临床病毒感染协作组, 《中华儿科杂志》编辑委员会. 儿童巨细胞病毒性疾病诊断和防治的建议[J]. 中华儿科杂志, 2012, 50(4): 290-292. doi: 10.3760/cma.j.issn.0578-1310.2012.04.013 Group of Infectious Diseases, Society of Pediatrics, Chinese Medical Association, National Cooperative Group of Pediatric Clinical Viral Infections, Editorial Board of Chinese journal of pediatrics. Suggestions on diagnosis and prevention of cytomegalovirus disease in children[J]. Chinese Journal of Pediatrics, 2012, 50(4): 290-292. doi: 10.3760/cma.j.issn.0578-1310.2012.04.013
[2]	金成, 白玲, 顾剑峰, 等. 异甘草酸镁对肝功能保护的临床疗效观察[J]. 中国医药, 2013, 8(2): 252. JIN C, BAI L, GU J F, et al. Clinical efficacy of magnesium isoglycyrrhiainate in protection of liver function of liver function [J]. China Medicine, 2013, 8(2): 252-253.
[3]	吴建明. 异甘草酸镁注射液治疗慢性乙型肝炎疗效观察[J]. 浙江临床医学, 2017, 19(6): 1076-1077. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX202043082.htm WU J M. Therapeutic effect of magnesium isoglycyrrhizinate injection on chronic hepatitis B[J]. Zhejiang Clinical Medical Journal, 2017, 19(6): 1076-1077. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX202043082.htm
[4]	杨美荣, 刘斌, 张国顺. 双环醇联合异甘草酸镁治疗药物诱导自身免疫性肝炎效果观察[J]. 中华实用诊断与治疗杂志, 2017, 31(3): 278-280. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201703023.htm YANG M R, LIU B, ZHANG G S. Bicyclol combined with magnesium isoglycyrrhizinate for drug-induced autoimmune hepatitis[J]. Journal of Chinese Practical Diagnosis and Therapy, 2017, 31(3): 278-280. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201703023.htm
[5]	叶贝. 儿童巨细胞病毒感染的研究进展[J]. 中国营养保健, 2016, 26(3): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB201914030.htm YE B. Research progress of cytomegalovirus infection in children[J]. China Health Care Nutrition, 2016, 26(3): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB201914030.htm
[6]	EGUCHI H, HORITA N, USHIO R, et al. Diagnosic test accuracy of antigenemia assay for polymerase chain reaction proven cytomegalovirus infection: Systematic review and meta-analysis[J]. Clin Microbiol Infect, 2017, 23(12): 907-915. doi: 10.1016/j.cmi.2017.05.009
[7]	陈国松, 周桂华, 朱双华. 异甘草酸镁对巨细胞病毒肝炎患儿肝功能生化指标的影响[J]. 中外医疗, 2017, 36(35): 48-50. CHEN G S, ZHOU G H, ZHU S H. Effect of magnesium isoglycyrrhizinate on biochemical indexes of liver function in children with cytommegalovirus hepatitis[J]. China Foreign Medical Treatment, 2017, 36(35): 48-50.
[8]	张自成, 梅冬雪, 刘斌, 等. 双环醇联合异甘草酸镁治疗失代偿期肝硬化疗效观察[J]. 中华实用诊断与治疗杂志, 2017, 31(1): 76-78. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201701024.htm ZHANG Z C, MEI D X, LIU B, et al. Effect bicyclol combined with magnesium isoglycyrrhizinate on decompensate cirrhosis[J]. Journal of Chinese Practical Diagnosis and Therapy, 2017, 31(1): 76-78. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201701024.htm
[9]	李荣霞, 陈真英, 刘翔, 等. 四逆汤加味联合异甘草酸镁治疗急性药物性肝损伤疗效及对氧化应激、体液免疫功能的影响[J]. 现代中西医结合杂志, 2018, 27(36): 4007-4011. doi: 10.3969/j.issn.1008-8849.2018.36.005 LI R X, CHEN Z Y, LIU X, et al. Effect of Sini Decoction combined with magnesium isoglycyrrhizinate on acute drug-induced liver injury and its effect on oxidative stress and humoral immune function[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2018, 27(36): 4007-4011. doi: 10.3969/j.issn.1008-8849.2018.36.005
[10]	茆玲, 冯彩云, 刘学燕. 甘草酸制剂治疗病毒性肝炎疗效观察[J]. 湖北中医药大学学报, 2016, 18(1): 67-69. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX201601020.htm MAO L, FENG C Y, LIU X Y. Clinical Observation of 3 Kinds of glycyrrhizic acid preparations in treatment of viral hepatitis with hyperbilirubinemia[J]. Journal of Hubei University of Chinese Medicine, 2016, 18(1): 67-69. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX201601020.htm
[11]	许少绵, 贺香毓, 丁志伟, 等. 天晴甘美在肝炎肝功能异常中的临床疗效观察[J]. 中国实用医药杂志, 2019, 14(2): 100-102. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201902058.htm XU S M, HE X Y, DING Z W, et al. Clinical observation of Tianqing Ganmei in abnormal liver function of hepatitis[J]. China Practical Medicine, 2019, 14(2): 100-102. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201902058.htm
[12]	李璐, 蔡晓红, 陈伟富, 等. 异甘草酸镁在新生儿巨细胞病毒性肝炎中的疗效研究[J]. 中国卫生检验检疫杂志, 2016, 26(11): 1570-1571, 1574. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ201611016.htm LI L, CAI X H, CHEN W F, et al. Effects research on magnesuim isoglycyrrhizinate in the treatment of infant cytomegalovirus hepatitis[J]. Chinese Journal of Health Laboratory Technology, 2016, 26(11): 1570-1571, 1574. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ201611016.htm
[13]	沈斌, 蒋利亚, 陈猛, 等. 药物利用评价和药物利用评估法评价我院慢性乙型肝炎住院患者保肝药物的使用情况[J]. 中华全科医学, 2016, 14(7): 1144-1146. doi: 10.16766/j.cnki.issn.1674-4152.2016.07.027 SHEN B, JIANG L Y, CHEN M, et al. Drug utilization review and drug utilization evaluation for evaluation of usage of hepatoprotective drugs in hospitalized patients with Chronic hepatitis B[J]. Chinese Journal of General Practice, 2016, 14(7): 1144-1146. doi: 10.16766/j.cnki.issn.1674-4152.2016.07.027
[14]	贺丽丽, 杨燕, 李维薇, 等. 婴儿巨细胞病毒肝炎中西医治疗进展[J]. 现代中西医结合杂志, 2017, 26(11): 1249-1251. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201711038.htm HE L L, YANG Y, LI W W, et al. Advances in TCM and western medicine treatment of infantile cytomegalovirus hepatitis[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2017, 26(11): 1249-1251. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201711038.htm
[15]	卢俞任, 韩冬梅. 更昔洛韦联合异甘草酸镁治疗婴儿巨细胞病毒(CMV)性肝炎的临床效果[J]. 中国医学创新, 2019, 16(29): 59-62. LU Y R, HAN D M. Effect of ganciclovir combined with magnesium isoglycyrrhizinate in the treatment of infant cytomegalovirus hepatitis[J]. Medical Innovation of China, 2019, 16(29): 59-62.