摘要
目的探究重组人干扰素α-1b联合大剂量丙种球蛋白治疗重症手足口病(HFMD)合并病毒性脑炎的临床效果。方法选取2014年2月至2017年4月宜宾市第二人民医院收治135例HFMD并病毒性脑炎患儿,按随机数字表法分为对照A组(重组人干扰素α-1b)、对照B组(大剂量丙种球蛋白)及观察组(重组人干扰素α-1b+大剂量丙种球蛋白),各45例。比较三组患儿疗效、治疗后血清胰岛素样生长因子-1(IGF-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、S100B、神经特异性烯醇化酶(NSE)水平及血清T细胞亚群水平变化情况。结果观察组总有效率(93. 33%)高于对照A组、B组(73. 33%、73. 56%),差异有统计学意义(P <0. 05)。治疗后,观察组CD3^+、CD4^+、CD4^+/CD8^+、CD8^+改善程度大于对照A、B组,血清IGF-1、IL-6、TNF-α、S100B、NSE改善程度大于对照A、B组,差异均有统计学意义(P <0. 05)。三组患儿不良反应发生率比较,差异无统计学意义(P> 0. 05)。结论重组人干扰素α-1b联合大剂量丙种球蛋白治疗重症HFMD并病毒性脑炎患儿疗效显著,能显著提高患儿免疫功能,减轻机体炎性反应,缓解脑损伤,调节IGF-1水平。
Objective To investigate the clinical effect of recombinant human interferon α-1b combined with high-dose gamma globulin on children with severe hand-foot-mouth disease (HFMD) and viral encephalitis. Methods A total of 135 children with HFMD and viral encephalitis from Feb 2014 to April 2017 in Yibin Second People’s Hospital were randomly divided into control group A (recombinant human interferon α-1b) and control group B (high-dose gamma globulin) and observation group (recombinant human interferon α-1b + high-dose gamma globulin) according to the random number table method, with 45 cases in each group.The therapeutic effects, serum insulin-like growth factor-1 (IGF-1), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), S100B, neuro-specific enolase (NSE) levels and changes in serum T cell subsets were compared among the three groups. Results The total effective rate of observation group (93.33%) was higher than that of control group A and B (73.33%, 73.56%)( P <0.05). After treatment, the improvement of CD3+, CD4+, CD4+/CD8+ and CD8+ was higher than that of control group A and B ( P <0.05);the improvement of serum IGF-1,IL-6, TNF-α, S100B and NSE in observation group was higher than that in control group A and B ( P <0.05);there was no significant difference in the incidence of adverse reactions among three groups ( P >0.05). Conclusions The clinical effect of children with severe HFMD and viral encephalitis treated by recombinant human interferon α-1b combined with high-dose gamma globulin is significant. It can significantly improve the immune function of the children, reduce the inflammatory response, alleviate brain damage and regulate the level of IGF-1.
作者
闵晓兰
蔡强
卢玉容
Min Xiaolan;CAI Qiang;LU Yurong(Department of Pediatrics, Second People’s Hospital of Yibin City, Yibin 644000, China)
出处
《安徽医学》
2019年第4期392-395,共4页
Anhui Medical Journal
基金
四川省卫生和计划生育委员会科研(项目编号:20150172)
作者简介
通信作者:蔡强,1492029003@qq.com.
