更昔洛韦注射液联合重组人干扰素α-1b治疗呼吸道合胞病毒肺炎患儿的疗效研究

doi:10.19871/j.cnki.xfcrbzz.2026.02.007

摘要/Abstract

摘要： 目的探究呼吸道合胞病毒（respiratory syncytial virus,RSV）肺炎患儿经更昔洛韦注射液联合重组人干扰素α-1b治疗的疗效分析,为临床RSV肺炎患儿治疗方案的选择提供参考依据。方法选取2021年12月至2023年12月在首都医科大学附属复兴医院确诊的105例RSV肺炎患儿（年龄3~8岁）为研究对象,采用随机数字表法将其分为联合组（35例）、对照组（35例）、常规组（35例）。联合组给予更昔洛韦注射液联合重组人干扰素α-1b治疗,对照组给予重组人干扰素α-1b治疗,常规组接受常规治疗（如降温、祛痰、止咳、氧疗、基础抗病毒等）。结果联合组总有效率（94.29%,33/35）显著高于对照组（68.57%,24/35）和常规组（57.14%,20/35）（均P<0.05）。联合组咳嗽[（3.96±0.88）d]、喘鸣音[（3.39±0.85）d]、呼吸困难[（1.62±0.30）d]等临床症状缓解时长,均显著短于对照组[分别为（6.35±1.17）d,（5.57±1.12）d,（3.27±0.69）d]和常规组[分别为（7.59±1.34）d,（6.89±1.27）d,（4.62±0.84）d]（均P<0.05）。治疗后,三组患儿肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）、降钙素原（procalcitonin,PCT）、白介素（interleukin,IL）-10、CD8⁺T淋巴细胞、免疫球蛋白E（immunoglobulin E,IgE）水平均较治疗前降低,CD4⁺T淋巴细胞水平均较治疗前升高,且联合组上述指标的改善幅度更显著（均P<0.05）。结论更昔洛韦注射液联合重组人干扰素α-1b能更好地改善RSV肺炎患儿的炎症反应以及临床症状,提高机体免疫功能,疗效确切且安全可靠。

关键词: 呼吸道合胞病毒肺炎, 重组人干扰素α-1b, 更昔洛韦注射液, 疗效

Abstract: Objective To investigate the therapeutic efficacy of ganciclovir injection combined with recombinant human interferon alpha-1b on children with respiratory syncytial virus (RSV) pneumonia, providing a basis for clinical diagnosis and treatment of RSV pneumonia. Method 105 pediatric patients with RSV pneumonia (admitted from December 2021 to December 2023, aged 3-8 years) were randomly separated into combination group (35 cases) , control group (35 cases), and regular group (35 cases) in Fu Xing Hospital, Capital Medical University. The regular group received conventional treatment, the control group was treated with recombinant human interferon α-1b, and the combination group was treated with ganciclovir injection combined with recombinant human interferon α-1b（including antipyretic, expectorant, antitussive, oxygen therapy and basic antiviral therapy）. Result The total effective rate of the combination group (94.29%, 33/35) was higher than that of the control group (68.57%, 24/35) and regular group (57.14%, 20/35) (all P<0.05). The improvement of clinical indicators such as cough[(3.96±0.88)d], wheezing[(3.39±0.85)d], and dyspnea[(1.62±0.30)d] in the combination group was better than that in the control group[(6.35±1.17)d, (5.57±1.12)d, (3.27±0.69)d, respectively] and regular group[(7.59±1.34)d, (6.89±1.27)d, (4.62±0.84)d, respectively] (all P<0.05). After treatment, the levels of tumor necrosis factor alpha (TNF-α), procalcitonin (PCT), interleukin (IL)-10, CD8⁺, and immunoglobulin E (IgE) in both groups of children decreased, while CD4⁺ increased. And the improvement amplitude of the combination group was higher than that of the control group and regular group (all P<0.05). Conclusion The combination of ganciclovir injection and recombinant human interferon α-1b can improve the clinical symptoms, reduce inflammatory response and improve immune function in children with RSV pneumonia, the efficacy is certain, with definite efficacy and good safety.

Key words: Respiratory syncytial virus pneumonia, Recombinant human interferon α-1b, Ganciclovir injection, Efficacy

中图分类号:

R563
R725.6

何耀红, 谭言国, 陈谨, 屈爽. 更昔洛韦注射液联合重组人干扰素α-1b治疗呼吸道合胞病毒肺炎患儿的疗效研究[J]. 新发传染病电子杂志, 2026, 11(2): 35-40.

He Yaohong, Tan Yanguo, Chen Jin, Qu Shuang. Study on the effect of ganciclovir injection combined with recombinant human interferon α-1b in the treatment of RSV pneumonia in children[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(2): 35-40.

参考文献

[1] HUME-NIXON M, GRAHAM H, RUSSELL F, et al.Review of the role of additional treatments including oseltamivir, oral steroids, macrolides, and vitamin supplementation for children with severe pneumonia in low-and middle-income countries[J]. J Glob Health, 2022, 12(1): 10005-10023.
[2] 唐绘卓,伍洪华,李小梅. 血清转化生长因子-β、白细胞介素-23在婴幼儿呼吸道合胞病毒肺炎患儿中的表达及其与病情严重程度的相关性[J/CD]. 新发传染病电子杂志, 2024, 9(3): 40-44.
[3] 杨琳,肖兴娟,朱翠平,等. 学龄前儿童呼吸道合胞病毒感染的流行病学特征及引起重症肺炎的危险因素[J]. 中华实验和临床病毒学杂志, 2024, 38(3): 263-268.
[4] HE L, YANG L, ZHANG H, et al.Efficacy and safety of interferon on neonates with respiratory syncytial virus pneumonia[J]. Exp Ther Med, 2020, 20(6): 220-227.
[5] CHEN L, SHI M, DENG Q, et al.A multi-center randomized prospective study on the treatment of infant bronchiolitis with interferon α1b nebulization[J]. PLoS One, 2020, 15(2): e0228391.
[6] 姚艳冬,李高芾,田丽姗,等. α-干扰素在抗病毒治疗中的应用与研究进展[J]. 中国药理学通报, 2024, 40(11): 2010-2014.
[7] MÄRTSON AG, STURKENBOOM MGG, KNOESTER M, et al. Standard ganciclovir dosing results in slow decline of cytomegalovirus viral loads[J]. J Antimicrob Chemother, 2022, 77(2): 466-473.
[8] ZHU WJ, ZHOU X, CAO J, et al.The effectiveness and safety of Tanreqing Injection combined with ganciclovir on the treatment of respiratory syncytial virus pneumonia in children: A protocol for systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2020, 99(38): e22356.
[9] 冯冰. 呼吸道合胞病毒肺炎患儿血清IgE及呼出气一氧化氮浓度变化及意义[D]. 广东:广州医科大学, 2019.
[10] 胡亚美,江载芳.诸福棠实用儿科学[M].第8版. 北京:人民卫生出版社, 2015: 936-941.
[11] 李天萍,黄霞飞,杨蕉,等. 呼吸道合胞病毒感染性肺炎患儿的TNF-α和IL-1β水平及TLR4信号通路作用初步探究[J]. 中华医院感染学杂志, 2020, 30(6):919-922.
[12] 陈清凤,蔡锋铭,余洽超,等. 重组人干扰素α-1b联合热毒宁治疗呼吸道合胞病毒感染肺炎的疗效及对患儿血清PCT、CRP及炎症因子水平的影响[J]. 海南医学, 2021, 32(11): 1438-1441.
[13] 于方圆,潘芬,蔡沁,等. 急性呼吸道感染住院患儿呼吸道合胞病毒分子流行特征分析[J]. 中华微生物学和免疫学杂志, 2024, 44(2): 134-141.
[14] GABER DA, ALNWISER MA, ALOTAIBI NL, et al.Design and optimization of ganciclovir solid dispersion for improving its bioavailability[J]. Drug Deliv, 2022, 29(1): 1836-1847.
[15] 张云栋,陈婷,李远光,等. 热毒宁注射液联合更昔洛韦注射液对呼吸道合胞病毒感染肺炎患儿血清炎症因子和T细胞亚群的影响[J]. 现代生物医学进展, 2022, 22(4): 718-721, 726.
[16] 彭娟,杨岁耀. 更昔洛韦联合丙种球蛋白对腺病毒肺炎患儿免疫球蛋白、T淋巴细胞亚群及炎症因子的影响[J]. 湖南师范大学学报(医学版), 2023, 20(4): 32-35.
[17] JIANG R, HAN B, SONG M, et al.Efficacy and safety of aerosol inhalation of recombinant human interferon α1b (IFNα1b) injection for noninfluenza viral pneumonia, a multicenter, randomized, double-blind, placebo-controlled trial[J]. J Inflamm (Lond), 2020, 17(1): 19-27.
[18] LOCKE MC, FOX LE, DUNLAP BF, et al.Interferon Alpha, but Not Interferon Beta, Acts Early To Control Chronic Chikungunya Virus Pathogenesis[J]. J Virol, 2022, 96(1): e0114321.
[19] 董伟然,张燕,安会波,等. 吸入用布地奈德联合重组人干扰素α-1b注射液雾化干预对呼吸道合胞病毒感染幼鼠模型血清白介素-13水平及CD2+T淋巴细胞占比的影响[J]. 实用心脑肺血管病杂志, 2022, 30(10): 75-80.
[20] 范建荣,毕研龙,范铭兴,等. 热毒宁联合雾化重组人干扰素α1b对儿童呼吸道合胞病毒感染肺炎的疗效及免疫功能影响[J]. 中华中医药学刊, 2021, 39(11): 189-192.
[21] 储开东, 邵志莉, 袁伯稳. 重组人干扰素α1b联合更昔洛韦对传染性单核细胞增多症合并肝功能异常患儿炎症免疫和肝功能的影响[J]. 中国医院用药评价与分析, 2023, 23(4):443-446, 451.
[22] HIJANO DR, SIEFKER DT, SHRESTHA B, et al.Type I Interferon Potentiates IgA Immunity to Respiratory Syncytial Virus Infection During Infancy[J]. Sci Rep, 2018, 8(1): 11034.
[23] TESARI CRNKOVI H, BENDELJA K, DRKULEC V, et al.Respiratory Syncytial Virus-Specific Antibodies and Atopic Diseases in Children: A 10-Year Follow-Up[J]. Pathogens, 2023, 12(4): 546-561.
[24] 张慧芳. RSV感染患儿血清IL-10、IFN-γ和IL-4水平的检测及其意义初探[D]. 大连:大连医科大学, 2021.
[25] DO Q, DAO TM, NGUYEN TNT, et al.Procalcitonin Identifies Bacterial Coinfections in Vietnamese Children with Severe Respiratory Syncytial Virus Pneumonia[J]. Biomed Res Int, 2020, 2020(1): 1-6.
[26] LAUBRETON D, DRAJAC C, ELÉOUËT JF, et al. Regulatory B Lymphocytes Colonize the Respiratory Tract of Neonatal Mice and Modulate Immune Responses of Alveolar Macrophages to RSV Infection in IL-10-Dependant Manner[J]. Viruses, 2020, 12(8): 822-838.