观察更昔洛韦联合静脉丙种球蛋白(intravenous immune globulin，IVIG)治疗婴儿巨细胞病毒性(cytomegalovirus, CMV)肝炎的疗效。

将2005年6月至2008年6月在本院住院确诊为巨细胞病毒性肝炎，并在本科治疗的90例患儿随机分成更昔洛韦＋静脉丙种球蛋白治疗组32例(A组)：常规保肝治疗基础上，加用更昔洛韦和静脉丙种球蛋白联合治疗。更昔洛韦治疗组30例(B组)：常规保肝治疗基础上，加用更昔洛韦治疗。对照组(C组，n＝28)：常规保肝治疗(本研究程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得患儿家属的知情同意，并与之签署临床研究知情同意书)。

三组患儿肝功能各项指标，总胆红素(total bilirubin, TBIL)和丙氨酸转氨酶(alanine aminotransferase, ALT)治疗前、后比较，差异有显著意义(P<0.05)，以A组改善更显著[TBIL：(186.78±20.93)μmol/L vs. (27.29±7.62)μmol/L ；ALT：(84.85±17.88)U/L vs. (34.35±8.21)U/L ]；三组患儿TBIL和ALT降至正常时间比较，差异有显著意义(P<0.05)，以A组所需时间最短[TBIL：(9.81±3.22)μmol/L ；ALT：(22.54±9.54)U/L ]。A，B组抗CMV-IgM转阴率(96.9%，90.0%)明显高于C组(3.6%，P<0.05)；B组中性粒细胞和血小板减少发生率(26.7%，23.3%)明显高于A组(9.4%，6.3%)和C组(3.6%，3.6%；P<0.05)，而三组心肌型肌肝激酶同工酶(MB isoenzyme of creatine kinase，CK-MB)升高和皮疹的发生率比较，差异均无显著意义(P>0.05)。

更昔洛韦联合静脉丙种球蛋白治疗巨细胞病毒性肝炎疗效好，不良反应少。

To investigate therapeutic effects of ganciclovir and intravenous immune globulin (IVIG) on infants with cytomegalovirus hepatitis (CMV).

From June 2005 to June 2008, 90 newborn who were diagnosed as cytomegalovirus hepatitis were divided into three groups. Group A (n=32) were treated with routine method+ gnciclovir+ intravenous immune globulin, group B (n=30) were treated with routine method+ ganciclovir, and group C (n=28) were treated with routine method only. Informed consent was obtained from all participants. After treatment, clinical situation, laboratory examination and virology result were compared among three groups.

There was significant difference in changes of liver function indexes(total bilirubin, TBIL; alanine aminotransferase, ALT) before and after treatment among groups (P<0.05), and the changes significantly improved in A group [TBIL: (186.78±20.93)μmol/L vs. (27.29±7.62)μmol/L; ALT: (84.85±17.88)U/L vs. (34.35±8.21)U/L]. There was significant difference in time of TBIL and ALT decreased to normal value among groups (P<0.05), especially group A [TBIL: (9.81±3.22)μmol/L, ALT: (22.54±9.54)U/L]. The negative rates of CMV-IgM in group A (96.9%)and B (90.0%) were significant higher than that of group C (3.6%) (P<0.05). The incidences of neutropenia and thrombocytopenia of group B (26.7%, 23.3%) were significantly higher than those of group A (9.4%, 6.3%) and group C (3.6%, 3.6%) (P<0.05). There was no significant difference in increase of CK-MB and incidences of rash among groups.

It is safe and effective to treat newborn hepatitis caused by cytomegalovirus with Ganciclovir and intravenous immune globulin, which should be suggested in clinical practice.