关键词: 巨细胞病毒性肝炎, 更昔洛韦, 谷胱甘肽, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of intravenous administration of ganciclovir and glutathione in the treatment of children with cytomegalovirus (CMV)-infected hepatitis. Methods A consecutive 112 children with CMV hepatitis were encountered in our hospital between January 2021 and June 2024, and all children received intravenous administration of ganciclovir and glutathione for 2 to 3 weeks. Serum interleukin-18 (IL-18), interferon-γ(IFN-γ) and tumor necrosis factor-α(TNF-α) levels were assayed by ELISA, and serum CMV DNA loads were determined by PCR. Results Of our series, the children with CMV hepatitis were found mild hepatitis (MH) in 74 cases and severe hepatitis (SH) in 38 cases; after treatment, serum ALT and total serum bilirubin levels in children with SH decreased from (244.7±25.9)U/L and (167.5±22.3)μmol/L to (45.5±11.0)U/L and (31.2±5.8)μmol/L, respectively, and serum biochemical parameters returned to normal in children with MH; serum IL-18 and TNF-α levels in children with SH decreased from (74.8±27.9)pg/L and (41.0±10.2)pg/ml to (42.2±12.3)pg/L and (35.3±7.9)pg/ml(P<0.05), respectively, and they reduced from (56.4±17.4)pg/L and (39.4±6.9)pg/ml to (35.1±10.7)pg/L and (28.7±5.8)pg/ml(P<0.05) in those with MH; serum CMV DNA load returned to negative in (7.5±2.2)d in children with MH, much shorter than [(13.0±5.5)d, P<0.05] in those with SH; all patients but one (2.6%)who died of liver failure with complicated pneumonia with CMV-infected hepatitis recovered in our series. Conclusion Intravenous administration of ganciclovir and glutathione in the treatment of children with CMV-infected hepatitis is efficacious, and the pediatrics should take care of those with SH and deal with any complications in time.

Key words: Cytomegalovirus hepatitis, Ganciclovir, Glutathione, Therapy