Ettinger N A, Selby P, Powles R, Milliken S, Gallagher C, Jameson B, Tryhorn Y, Stern H
Department of Microbiology, Royal Marsden Hospital, Surrey, UK.
J Antimicrob Chemother. 1989 Jul;24(1):53-62. doi: 10.1093/jac/24.1.53.
Sixteen bone marrow transplant recipients with cytomegalovirus pneumonia diagnosed by rapid, non-invasive methods were treated with ganciclovir. Seven patients survived the acute infection and there were five long term survivors. Excellent in-vivo suppression of cytomegalovirus was observed. Marrow toxicity was noted in four patients but was rapidly reversible and not life threatening. Clinical features common to surviving patients included good clinical condition, insidious development of infection and evidence of normal alveolar gas exchange. The fulminant onset of symptoms, radiographic abnormalities and hypoxaemia were characteristic of non-survivors. These results offer some encouragement towards further study of ganciclovir for the early treatment of cytomegalovirus pneumonia. To identify such patients, the use of rapid diagnostic methods and aggressive viral surveillance is recommended. Convincing evidence for the efficacy of this drug will only emerge from randomized prospective studies.
16名通过快速、非侵入性方法诊断为巨细胞病毒性肺炎的骨髓移植受者接受了更昔洛韦治疗。7名患者在急性感染中存活，5名患者长期存活。观察到对巨细胞病毒有出色的体内抑制作用。4名患者出现骨髓毒性，但可迅速逆转，不危及生命。存活患者共有的临床特征包括临床状况良好、感染发展隐匿以及肺泡气体交换正常的证据。症状的暴发性发作、影像学异常和低氧血症是非存活者的特征。这些结果为进一步研究更昔洛韦用于巨细胞病毒性肺炎的早期治疗提供了一些鼓励。为了识别此类患者，建议使用快速诊断方法和积极的病毒监测。只有随机前瞻性研究才能提供该药物疗效的确凿证据。
