膦甲酸钠治疗血液病患者合并EB病毒感染的临床疗效

发布时间：2018-03-11 03:34

本文选题：膦甲酸钠　切入点：EBV感染　出处：《山东大学学报(医学版)》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨膦甲酸钠治疗血液病合并EBV感染患者,改善患者EBV血症的临床疗效、安全性及临床意义。方法回顾性分析2014年1月至2015年10月收治的血液病合并EBV感染患者112例,其中男70例,女42例,分为恶性血液病组(n=94例)和非恶性血液病组(n=18例),根据有无巨细胞病毒(CMV)感染以及是否接受骨髓移植治疗,恶性血液病组分为单纯EBV感染和合并CMV感染组,化疗组和骨髓移植组。以上患者均给予膦甲酸钠,60 mg/(kg·d),每12 h给药,每次静脉滴注至少3 h;疗程14 d,每周复查血常规、EBV病毒DNA定量和肝肾功,评价其治疗效果及不良反应。结果应用膦甲酸钠治疗血液病合并EBV感染患者总有效率72.3%,其中恶性血液病组有效率72.3%,非恶性血液病组有效率72.2%。两组差异无统计学意义(P0.05)。采用非参数秩和检验进行不同年龄、性别之间的疗效比较,各组差异无统计学意义(P0.05)。在恶性血液病组中,合并CMV感染组疗效比单纯EBV感染组好,差异有统计学意义(P0.05),而化疗组和骨髓移植组相比疗效差异无统计学意义(P0.05)。治疗后各组患者EBV的DNA拷贝数有不同程度下降,用药达到有效中位时间为10.3~14.5 d。不良反应主要有恶心、心慌等症状,均可耐受。结论膦甲酸钠治疗血液病患者的EBV感染具有较好的有效性,不良反应较少,安全可耐受。
[Abstract]:Objective to investigate the efficacy, safety and clinical significance of phosphonium formate in treating patients with hematologic diseases complicated with EBV infection, and to improve the clinical efficacy, safety and clinical significance of EBV. Methods 112 patients with hematologic diseases complicated with EBV infection from January 2014 to October 2015 were retrospectively analyzed. Among them, 70 males and 42 females were divided into malignant hematopathy group (n = 94) and non-malignant hematopathy group (n = 18). According to the presence of cytomegalovirus (CMV) infection and whether or not to receive bone marrow transplantation, The patients with malignant hematologic diseases were divided into EBV infection group, CMV infection group, chemotherapy group and bone marrow transplantation group. Each intravenous drip was given for at least 3 hours, the course of treatment was 14 days, and the blood routine examination of EBV DNA quantification and liver and kidney function were performed every week. Results the total effective rate was 72.3% in patients with hematologic diseases complicated with EBV infection, including 72.3% in malignant hematopathy group and 72.2% in non-malignant hematopathy group. There was no significant difference between the two groups. The nonparametric rank sum test was used for different ages. There was no significant difference between the two groups (P 0.05). In the malignant hematological disease group, the effect of CMV infection group was better than that of the simple EBV infection group. The difference was statistically significant (P 0.05), but there was no significant difference between the chemotherapy group and the bone marrow transplantation group (P 0.05). After treatment, the DNA copy number of the patients in each group decreased to some extent, and the median time to reach the effective time was 10.314.5 days. The adverse reactions were mainly nausea. Conclusion Phosphoformate is effective in treating EBV infection in patients with hematologic diseases, and has less adverse reactions and is safe and tolerable.
【作者单位】：山东大学附属省立医院血液科;
【基金】：国家自然科学基金(81473486,81270598) 国家公共卫生大研究基金会(201202017) 山东省自然科学基金(ZR2012HZ003,2009ZRB14176) 山东省科技攻关计划(2014GSF118021,2010GSF10250,2008GG2NS02018) 山东省医学领军人才基金泰山学者基金
【分类号】：R511;R55

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