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三叉神经根手术后应用人白细胞干扰素预防单纯疱疹病毒再激活感染

Prevention of reactivated herpes simplex infection by human leukocyte interferon after operation on the trigeminal root.

作者信息

Pazin G J, Armstrong J A, Lam M T, Tarr G C, Jannetta P J, Ho M

出版信息

N Engl J Med. 1979 Aug 2;301(5):225-30. doi: 10.1056/NEJM197908023010501.

Abstract

Microneurosurgical procedures on the trigeminal-nerve root are often followed by reactivation of herpes simplex virus infection, manifested by herpes labialis or oropharyngeal herpesvirus shedding or both. In a double-blind study of the ability of human leukocyte interferon to prevent this reactivation, patients with a history of herpes labialis were given 7 x 10(4) U of interferon per kilogram of body weight per day or placebo for five days beginning on the day before operation. In 18 patients treated with placebo, herpes labialis developed in 10, and virus shedding in the oropharynx in 15. In 19 patients treated with interferon, lesions developed in five, and shedding in eight. The frequency of reactivation as measured by lesions or positive throat cultures or both was significantly reduced by interferon (P less than 0.05). Of 127 daily throat-wash cultures in the placebo group, 42 per cent were positive for herpesvirus, but of 134 in the interferon group, only 9 per cent were positive (P less than 0.001). We conclude that interferon at a well-tolerated dosage reduces reactivation of latent herpes simplex virus infection after a potent operative stimulus.

摘要

三叉神经根的显微神经外科手术之后,单纯疱疹病毒感染常被重新激活,表现为唇疱疹或口咽疱疹病毒脱落,或两者皆有。在一项关于人白细胞干扰素预防这种重新激活能力的双盲研究中,有唇疱疹病史的患者在手术前一天开始,每天每千克体重给予7×10⁴单位的干扰素或安慰剂,持续五天。在18例接受安慰剂治疗的患者中,10例出现唇疱疹,15例口咽出现病毒脱落。在19例接受干扰素治疗的患者中,5例出现病变,8例出现脱落。通过病变或咽喉培养阳性或两者来衡量的重新激活频率,干扰素使其显著降低(P<0.05)。在安慰剂组的127次每日咽喉冲洗培养中,42%的疱疹病毒呈阳性,但在干扰素组的134次培养中,只有9%呈阳性(P<0.001)。我们得出结论,在耐受良好的剂量下,干扰素可降低强效手术刺激后潜伏单纯疱疹病毒感染的重新激活。

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