Analysis of the Application Effect of Bicyclol Combined with Ganciclovir in the Treatment of EB Virus-Related Infectious Mononucleosis in Children Based on Liver Function，IgA，IgM，and IgG Levels
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摘要:
目的 探究基于肝功能、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）水平分析双环醇联合更昔洛韦治疗对EB病毒相关传染性单核细胞增多症（IM）患儿的应用效果。 方法 选取2019年1月至2024年1月宿松县人民医院收治的150例EB病毒感染IM患儿作为研究对象，并采用数字表达法对其行随机分组，分为对照组和观察组（均n = 75）。患儿入院后均接受常规对症治疗，对照组患儿采用更昔洛韦治疗，观察组患儿在对照组基础上联合双环醇治疗；两组均接受7 d的治疗。对比两组的治疗效果；对比两组治疗前后肝功能指标、免疫球蛋白指标、生活质量；对比两组不良反应率。 结果 观察组治疗总有效率为93.33%（70/75），高于对照组的61.33%（46/75）（P < 0.05）；治疗后两组肝功能指标均有显著降低，且观察组更低（均P < 0.05）；治疗后两组免疫球蛋白指标均有显著升高，且观察组更高（均P < 0.05）；治疗后两组生活质量各项评分均有显著升高，且观察组更高（均P < 0.05）；观察组总不良反应率为6.67%（5/75）高于对照组的5.33%（4/75），但二者对比差异无统计学意义（P > 0.05）。 结论 对EB病毒相关IM应用双环醇联合更昔洛韦治疗，可显著提升患儿治疗效果，改善患儿的肝功能和免疫球蛋白指标，提高患儿生活质量，且不良反应相对较低，临床疗效和安全性均较高。 -
关键词:
- EB病毒 /
- 传染性单核细胞增多症 /
- 肝功能 /
- 免疫功能 /
- 疗效
Abstract:Objective To explore the application effect of bicyclol combined with ganciclovir in the treatment of children with Epstein-barr virus related infectious mononucleosis （IM） based on liver function, immunoglobulin A （IgA）, immunoglobulin M （IgM） and immunoglobulin G （IgG） levels. Methods A total of 150 children with EB virus infected and IM admitted to the People's Hospital of Susong County from January 2019 to January 2024 were selected as the study subjects. Random grouping was performed using a digital expression method, dividing them into a control group and an observation group （n = 75 each）. All children received routine symptomatic treatment upon admission. The control group were treated with ganciclovir, while the observation group were treated with bicyclol in addition to ganciclovir. Both groups underwent treatment for 7 days. The therapeutic effects , liver function indexes, immunoglobulin indexes, quality of life, and adverse reaction rates were compared between the two groups. The therapeutic effects, liver function indicators, immunoglobulin indicators, quality of life, and adverse reaction rates were compared between the two groups. Results The total effective rate of treatment in the observation group was 93.33% （70/75）, which was significantly higher than that of control group （61.33% （46/75） （P < 0.05）. After treatment, the liver function indexes of both groups were significantly decreased, and the observation group showing lower levels （all P < 0.05）. After treatment, immunoglobulin indexes were significantly increased in both groups, with the observation group having higher levels （P < 0.05）. After treatment, the scores of life quality in both groups significantly increased, and those in observation group were higher （all P < 0.05）. Quality of life scores significantly improved in both groups, with the observation group achieving higher scores （P < 0.05）. The total adverse reaction rate in the observation group was 6.67% （5/75）, compared to 5.33% （4/75） in the control group, but there was no significant difference between the two groups （P > 0.05）. Conclusion The application of bicyclol combined with ganciclovir in the treatment of Epstein-barr virus related IM can significantly improve the therapeutic effect, improve liver function and immunoglobulin indexes, and improve the quality of life in children, with relatively low adverse reactions, demonstrating high clinical efficacy and safety. -
Key words:
- Epstein-barr virus /
- Infectious mononucleosis /
- Liver function /
- Immune function /
- Efficacy
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表 1 两组基线资料对比[$\bar x \pm s $/n（%），n = 75]
Table 1. Comparison of baseline data between two groups[$\bar x \pm s $/n（%），n = 75]
组别 性别−男 年龄（岁） 病程（d） 脾脏肿大 EB病毒载量（×103拷贝/mL） 对照组 42（56.00） 6.56 ± 1.56 4.72 ± 1.68 32（42.67） 1.11 ± 0.44 观察组 44（58.67） 6.48 ± 1.62 4.67 ± 1.72 34（45.33） 1.12 ± 0.45 χ2/t 0.109 0.308 0.180 0.108 −0.138 P 0.741 0.758 0.857 0.742 0.891 组别 体温（℃） 浅表淋巴结直径（cm） 浅表淋巴结硬度−中等硬度 浅表淋巴结硬度−高等硬度 咽峡炎 对照组 39.70 ± 0.10 2.10 ± 0.33 51（68.00） 24（32.00） 20（26.67） 观察组 39.67 ± 0.12 2.12 ± 0.35 53（70.67） 22（29.33） 19（25.33） χ2/t 1.663 −0.360 0.125 0.125 0.035 P 0.098 0.719 0.723 0.723 0.852 
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表 2 两组疗效对比[n（%），n = 75]
Table 2. Comparison of efficacy between two groups [n（%），n = 75]
组别 显效 有效 无效 总有效率 对照组 15（20.00） 31（41.33） 29（38.67） 46（61.33） 观察组 32（42.67） 39（52.00） 5（6.67） 70（93.33） χ2 21.907 P < 0.001* *P < 0.05。
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表 3 肝功能水平对比[$\bar x \pm s $，n = 75]
Table 3. Comparison of liver function levels[$\bar x \pm s $，n = 75]
组别 AST（U/L） ALT（U/L） PIVKA−II（mAU/mL） 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 189.37 ± 20.35 89.56 ± 5.13∆ 142.62 ± 12.17 86.52 ± 4.86∆ 110.51 ± 16.02 46.98 ± 7.76∆ 观察组 187.98 ± 20.53 47.38 ± 4.52∆ 143.35 ± 11.95 46.33 ± 3.02∆ 111.34 ± 16.18 22.85 ± 5.02∆ t 0.416 −53.427 0.371 −60.829 0.316 −22.611 P 0.678 < 0.001* 0.711 < 0.001* 0.753 < 0.001* *P < 0.05；与治疗前比较，∆P < 0.05。
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表 4 免疫球蛋白水平对比[$\bar x \pm s $，n = 75]
Table 4. Comparison of immunoglobulin levels[$\bar x \pm s $，n = 75]
组别 IgA（g/L） IgG（g/L） IgM（g/L） 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 0.96 ± 0.25 1.38 ± 0.43∆ 7.85 ± 1.01 9.32 ± 1.06∆ 1.35 ± 0.55 1.56 ± 0.45∆ 观察组 0.95 ± 0.22 1.92 ± 0.51∆ 7.83 ± 1.04 11.85 ± 1.73∆ 1.33 ± 0.51 1.96 ± 0.76∆ t −0.260 7.010 −0.119 10.799 −0.231 3.922 P 0.795 < 0.001* 0.905 < 0.001* 0.818 < 0.001* *P < 0.05；与治疗前比较，∆P < 0.05。
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表 5 生活质量评分对比[$\bar x \pm s $，n = 75]
Table 5. Comparison of quality of life scores[$\bar x \pm s $，n = 75]
组别 治疗前 治疗后 对照组 55.23 ± 4.39 72.33 ± 4.62∆ 观察组 54.17 ± 4.23 90.56 ± 4.86∆ t −1.506 23.544 P 0.134 < 0.001* *P < 0.05；与治疗前比较，∆P < 0.05。
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表 6 两组不良反应发生率对比[n（%），n = 75]
Table 6. Comparison of Adverse Reaction Incidence between two groups [n（%），n = 75]
[n（%），n = 75]组别 贫血 嗜睡 皮疹 腹泻 总不良反应发生率 对照组 1（1.33） 1（1.33） 1（1.33） 1（1.33） 4（5.33） 观察组 1（1.33） 2（2.67） 1（1.33） 1（1.33） 5（6.67） χ2 0.000 P 1.000a a为连续校正卡方检验。
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