双歧杆菌三联活菌联合更昔洛韦对新生儿巨细胞病毒肝炎的治疗效果

摘要/Abstract

摘要： 目的探讨双歧杆菌三联活菌联合更昔洛韦对新生儿巨细胞病毒肝炎的治疗效果。方法纳入2021年1月至2024年1月在南阳市中心医院治疗的106例巨细胞病毒肝炎患儿,分为观察组与对照组,每组53例。对照组使用更昔洛韦,观察组使用更昔洛韦和双歧杆菌三联活菌。记录患儿症状消退时间,并比较两组治疗前后的病毒载量、免疫功能、发育情况和肝功能。记录治疗期间不良反应发生情况。结果观察组患儿巩膜黄染、皮肤黄染、恶心呕吐、腹胀症状改善时间分别为(5.76±1.03)d、(4.23±0.61)d、(2.79±0.52)d、(2.72±0.43)d,均短于对照组;观察组和对照组治疗后的病毒载量分别为(8.93±1.08)拷贝/mL和(11.42±1.46)拷贝/mL,观察组低于对照组;两组治疗后CD4⁺/CD8⁺分别为(2.03±0.41)和(11.79±0.35),观察组高于对照组。结论双歧杆菌三联活菌联合更昔洛韦有助于提高新生儿巨细胞病毒肝炎的治疗效果。

关键词: 双歧杆菌三联活菌, 更昔洛韦, 巨细胞病毒肝炎, 新生儿

Abstract: Objective To investigate the therapeutic effect of Bifidobacterium tri-species probiotics combined with ganciclovir in neonatal cytomegalovirus (CMV) hepatitis. Methods A total of 106 neonates diagnosed with CMV hepatitis were treated between January 2021 and January 2024 in Nanyang Central Hospital. They were subsequently randomized into two groups, comprising 53 patients in each.The control group received ganciclovir alone, while the observation group received Bifidobacterium tri-species probiotics in addition to ganciclovir. After 3 weeks of treatment, evaluations were performed. The time of symptom resolution was recorded. Adverse reactions during treatment were also documented. Results The time for symptom improvement in the observation group for scleral jaundice [(6.23±1.21)days, (4.97±0.89)days, (3.40±0.84)days, (3.31±0.69) days], with differences being statistically significant (P<0.05). Post-treatment, the observation group showed a significantly lower viral load of (8.93±1.08) copies/mL and a higher CD4⁺/CD8⁺ ratio of (2.03±0.41) compared to the control group, with statistical significance (P<0.05). Conclusion The combination of bifidobacterium tri-species probiotics and ganciclovir significantly enhances the therapeutic effect in neonates with CMV hepatitis.

Key words: Bifidobacterium tri-species probiotics, Ganciclovir, Cytomegalovirus hepatitis, Neonates

王品, 张靖, 任亚方. 双歧杆菌三联活菌联合更昔洛韦对新生儿巨细胞病毒肝炎的治疗效果[J]. 肝脏, 2026, 31(3): 441-444.

WANG Pin, ZHANG Jing, REN Ya-fang. Efficacy of bifidobacterium tri-species probiotic combination with ganciclovir in the treatment of neonatal cytomegalovirus hepatitis[J]. Chinese Hepatolgy, 2026, 31(3): 441-444.

/ 推荐

参考文献

[1] Saito H, Sakai K, Tanaka M, et al. Economic evaluation of newborn screening for congenital cytomegalovirus infection: a systematic review[J]. Eur J Pediatr, 2025, 184(1):123.
[2] 吴培豪,周俞,吴开奇,等. 巨细胞病毒感染新生儿血清IgM抗体和病毒载量与临床症状的相关性研究[J]. 中华预防医学杂志, 2022, 56(11):1642-1647.
[3] 郭燕,徐利,郑钦亮,等. 新生儿巨细胞病毒感染致听力受损的危险因素分析及列线图预测模型构建[J]. 中华实验和临床病毒学杂志,2023,37(4):398-403.
[4] Ortiz-Gracia A, Ríos M, Tobías E,et al. Assessment of mitochondrial toxicity in newborns and infants with congenital cytomegalovirus infection treated with valganciclovir[J]. Arch Dis Child, 2022, 107(7):686-691.
[5] Underwood M A, Mukhopadhyay S, Lakshminrusimha S,et al. Neonatal intestinal dysbiosis[J]. J Perinatol, 2020, 40(11):1597-1608.
[6] 吴伟丽,丁军. 双歧杆菌三联活菌散联合熊去氧胆酸对新生儿巨细胞病毒性肝炎的疗效[J]. 中国微生态学杂志,2023, 35(10):1201-1206.
[7] 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.
[8] Sunil-Chandra N P, Jayasundara M V M L, Gunathilaka M G R S S,et al. Human cytomegalovirus (HCMV) trends in Sri Lanka: insights from a hospital-based seroprevalence analysis[J]. BMC Infect Dis, 2025, 25(1):184.
[9] Dobbins G C, Kimberlin D W, Ross S A. Cytomegalovirus variation among newborns treated with valganciclovir[J]. Antiviral Res, 2022, 203:105326.
[10] Ma G, Shi Y, Meng L,et al. Factors affecting the early establishment of neonatal intestinal flora and its intervention measures[J]. Front Cell Infect Microbiol, 2023, 13:1295111.
[11] 蒋宇桐,曾瑞,冯洁,等. 益生菌辅助更昔洛韦治疗新生儿人巨细胞病毒肝炎后的疾病转归观察[J]. 肝脏, 2024, 29(8):990-993, 1014.
[12] Su Z, Kang Y. Influences of bifid triple viable capsules plus cetirizine on gut microbiota and immune function in children with eczema[J]. Drug Des Devel Ther, 2022, 16:2509-2515.
[13] Shao T, Zhao C, Li F,et al. Intestinal HIF-1α deletion exacerbates alcoholic liver disease by inducing intestinal dysbiosis and barrier dysfunction[J]. J Hepatol, 2018, 69(4):886-895.
[14] Mishra G, Singh P, Molla M,et al. Harnessing the potential of probiotics in the treatment of alcoholic liver disorders[J]. Front Pharmacol, 2023, 14:1212742.
[15] 赵婧芳,游晶. 肠道菌群失调与肝脏疾病的相关性研究进展[J]. 海南医学院学报, 2023, 29(16):1269-1275.
[16] 赵丘童,黄涛. 双歧杆菌三联活菌胶囊治疗乙型肝炎失代偿期肝硬化疗效及对肠道菌群、肠黏膜屏障的影响[J]. 现代中西医结合杂志, 2024, 33(9):1253-1256,1302.
[17] 谢秀春,于瑛,王苗,等. 小儿退黄健脾免煎颗粒联合双歧杆菌三联活菌散辅助治疗新生儿黄疸疗效[J]. 中国计划生育学杂志,2024, 32(12):2792-2795.
[18] Kang S, Lin Z, Xu Y,et al. A recombinant bifidobacterium bifidum BGN4 strain expressing the streptococcal superoxide dismutase gene ameliorates inflammatory bowel disease[J]. Microb Cell Fact, 2022, 21(1):113.
[19] Chen L, Liu Y, Zhang Y, et al. Superoxide dismutase ameliorates oxidative stress and regulates liver transcriptomics to provide therapeutic benefits in hepatic inflammation[J]. PeerJ, 2023 11:e15829.
[20] 谭从容. 培菲康联合更昔洛韦治疗小儿巨细胞病毒性肝炎的效果观察[J]. 中国妇幼健康研究, 2017, 28(2):200-202.
[21] 罗明海,张森山. 更昔洛韦联合双歧杆菌三联活菌治疗小儿巨细胞病毒感染性肝炎的有效性和安全性分析[J]. 肝脏,2019, 24(4):452-454.
[22] Cevik M, Russell C D, Ong D S Y. Challenges of interpreting cytomegalovirus DNAemia and its potential association with chronic lung disease in children and adolescents with perinatally acquired human immunodeficiency virus infection[J]. Clin Infect Dis, 2020, 70(5):989-990.
[23] Jedlińska-Pijanowska D, Czech-Kowalska J, Kłodzińska M,et al. Antiviral treatment in congenital HCMV infection: the six-year experience of a single neonatal center in Poland[J]. Adv Clin Exp Med, 2020, 29(10):1161-1167.