抗疱疹病毒核苷类药物对成人传染性单核细胞增多症有效性的研究-现代医学

抗疱疹病毒核苷类药物对成人传染性单核细胞增多症有效性的研究

单位：1. 解放军964医院感染科, 吉林长春 130060;
2. 重庆医科大学附属永川医院感染科, 重庆 402160

分类号：R512.7

出版年·卷·期（页码）：2023·51·第五期（660-665）

摘要：

目的：探讨抗疱疹病毒核苷类药物对成人传染性单核细胞增多症的有效性。方法：回顾性分析219例成人传染性单核细胞增多症患者的临床资料，统计患者一般资料、治疗前临床症状、治疗前实验室检查、症状转归、实验室检查转归5大项23个观察指标，按是否应用抗疱疹病毒核苷类药物分为抗病毒治疗组和对照组，初步比较两组间各观察指标的差异；而后以一般资料、治疗前临床症状、治疗前实验室检查3大项14个指标为匹配变量进行1∶1倾向性匹配分析，比较组间症状转归、实验室检查转归的差异。结果：倾向性匹配前两组间年龄、发热分度、淋巴结肿大、异型淋巴细胞比率、肝功能、血清EBV-DNA水平差异有统计学意义。倾向性匹配得到抗病毒治疗组和对照组各68例；两组治疗前各观察指标差异无统计学意义。治疗后，发热消退及淋巴结消退时间对照组优于抗病毒治疗组，差异有统计学意义。结论：对成人传染性单核细胞增多症，使用抗疱疹病毒核苷类药物，相较于对照组，临床症状转归时间和实验室指标转归时间等指标方面并未表现出更多优势。

Objective: To investigate the efficacy of anti-herpetic virus nucleoside drugs in the treatment of adult infectious mononucleosis. Methods: The clinical data of 219 adult patients with infectious mononucleosis were analyzed retrospectively. 23 observation indicators of 5 major items were collected, including general information of patients, clinical symptoms and laboratory tests before treatment, symptom outcomes, and laboratory test outcomes. The patients were divided into antiviral treatment group and control group according to whether anti-herpetic virus nucleosides were used. The differences of observation indexes between the two groups were compared. Then, 1:1 propensity matching analysis was conducted by using 14 indicators from three major items,i.e.,general information, clinical symptoms before treatment, and laboratory tests before treatment as matching variables to compare the differences in symptom outcomes and laboratory test outcomes between the two groups. Results: Before propensity score matching there were significant differences in age, fever grade, lymphadenopathy, heterotypic lymphocyte ratio, liver function and serum EBV-DNA level between the two groups. Propensity score matching showed that there were 68 cases in antiviral treatment group and 68 cases in the control group. There was no statistical difference between the two groups in each observation index before treatment. After antiviral treatment, the time of fever regression and lymph node regression in the control group was better than that in the antiviral treatment group, and the results were statistically different. Conclusion: Compared with the control group, the antiviral group does not exhibit more advantages in terms of clinical symptom response time and laboratory indicator response time.

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