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目的:观察2种更昔洛韦给药方式治疗儿童EB病毒感染的成本-效果。方法:将EB病毒感染患儿90例,根据给药方式不同分为观察组和对照组。2组根据病情给予对症治疗,若合并细菌感染酌情使用抗生素,使用更昔洛韦控制EB病毒。观察组患儿使用更昔洛韦5mg/(kg/次),12小时1次:对照组使用更昔洛韦10mg/kg/d,1天1次:7天为1个疗程。观察患儿体温、咽峡扁桃体、淋巴结、肝脾大小等主要临床表现变化,以及EBV-DNA-PCR、血常规、异形淋巴细胞、肝功能等变化情况。结果:治疗1个疗程后,治疗组60例中临床显效25例(41.7%),有效33例(55.0%),无效2例(3.3%),总有效率96.7%;对照组60例中显效15例(25.0%),有效25例(41.7%),无效20例(33.3%),总有效率66.9%。更昔洛韦分次给药分次给药效果(96.7%)优于单次给药(66.9%),P<0.05。成本-效果分析显示观察组产生单位效益费用较对照组少10.3元。结论:更昔洛韦分次给药较单次给药效价比高,是治疗儿童EB病毒感染的优选方案。
Objective: To observe the cost-effectiveness of two ganciclovir administrations in treating children with Epstein-Barr virus infection. Methods: Ninety children with Epstein-Barr virus infection were divided into observation group and control group according to different administration methods. 2 groups were given symptomatic treatment according to the condition, if the combined bacterial infection, as appropriate, the use of antibiotics, the use of ganciclovir control of Epstein-Barr virus. The observation group used ganciclovir 5mg / (kg / time), once every 12 hours: the control group used ganciclovir 10mg / kg / d, once a day: 7 days for a course of treatment. The changes of body temperature, pharyngeal amygdala, lymph nodes, liver and spleen size and other major clinical manifestations were observed, and the changes of EBV-DNA-PCR, blood routine, abnormal lymphocytes and liver function were observed. Results: After one course of treatment, the clinical efficacy of the treatment group was significantly improved in 25 cases (41.7%), effective in 33 cases (55.0%), ineffective in 2 cases (3.3%), and the total effective rate was 96.7% 15 cases (25.0%), effective in 25 cases (41.7%), ineffective in 20 cases (33.3%), the total effective rate was 66.9%. Administration of ganciclovir in divided doses (96.7%) was superior to single administration (66.9%), P <0.05. Cost-effectiveness analysis showed that the observation group produced unit cost of 10.3 yuan less than the control group. Conclusion: Ganciclovir is more effective than single administration in the treatment of children with Epstein-Barr virus infection.