阿昔洛韦对病毒性脑膜炎患儿神经功能及细胞因子的作用

摘要

OBJECTIVE:To observe the effect of acyclovir on neurological function and cytokines of children with viral menin-gitis. METHODS:Totally 70 children with viral meningitis were randomly divided into control group and observation group. All children were given routine treatment,including defervescence,reducing intracranial pressure and regulating water and electrolyte balance,etc. Based on it,the control group was treated by Ribavirin glucose injection 15 mg/kg,iv,bid;observation group was treated by Acyclovir glucose injection 5 mg/kg,iv,tid. The course for both was 7 d. The clinical data was compared,including the vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9) in cerebrospinal fluid (CSF) and serum,insu-lin-like growth factor-Ⅱ(IGF-Ⅱ) and insulin like growth factor binding protein-3(IGFBP-3) in CSF before and after treatment and the incidence of adverse reactions. There were no obvious adverse reactions during the treatment. RESULTS:After treatment, the VEGF and MMP-9 in serum and the VEGF,MMP-9,IGF-Ⅱ and IGFBP-3 in CSF in 2 groups were significantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There was no adverse reactions in 2 groups during the treatment. CONCLUSIONS:Compared with ribavirin,acyclovir can more obviously improve the neurological function and cytokines of children with viral meningitis,with similar safety.%目的：观察阿昔洛韦对病毒性脑膜炎患儿神经功能及细胞因子的作用。方法：70例病毒性脑膜炎患儿随机均分为对照组和观察组。两组患儿均给予退热、降低颅内压、调节水电解质平衡等常规治疗。在此基础上，对照组患儿给予利巴韦林葡萄糖注射液15 mg/kg静脉滴注，每日2次；观察组患儿给予阿昔洛韦葡萄糖注射液5 mg/kg静脉滴注，每日3次。两组患儿疗程均为7 d。观察两组患儿治疗前后血清及脑脊液中内皮生长因子（VEGF）、基质金属蛋白酶9（MMP-9）及脑脊液中胰岛素样生长因子Ⅱ（IGF-Ⅱ）、胰岛素样生长因子结合蛋白3（IGFBP-3）水平及不良反应发生情况。结果：治疗后，两组患儿血清及脑脊液中VEGF、MMP-9及脑脊液中IGF-Ⅱ、IGFBP-3水平均显著低于同组治疗前，且观察组低于对照组，差异均有统计学意义（P＜0.05）。两组患儿均未见明显不良反应发生。结论：阿昔洛韦较利巴韦林可更显著地改善病毒性脑膜炎患儿的神经功能及细胞因子，安全性相当。