丙种球蛋白及干扰素治疗手足口病并发病毒性脑炎疗效观察

摘要

Objective Objective To observe the effect of gamma globulin and interferon in the treatment of children with hand foot mouth disease (HFMD) combined with viral encephalitis.Methods 87 patients with HFMD collected from December 2012 to December 2013 were randomly divided into three groups. The human gamma globulin treated group ,including 30 ca‐ses ,was given 1 g/(kg・d) human gamma globulin iv for 5 days;the interferon treated group ,including 27 cases ,were given 80 μg/d im for 3 days ;the combined group ,including 30 cases ,were given combined treatment with both human gamma glob‐ulin and interferon. The other treatments and nursing methods in depressing intracranial pressure ,bringing down the fever , preventing bacterial infection and nourishing brain cells in the three groups were the same. The improvement of symptoms in a week ,clinical effect and safety of the three groups were observed.Results No significant difference was observed in the recov‐ery time (P>0.05). The fever process ,extinction time of herpes and the turning time of nervous system pathology in the com‐bined treatment group were significantly shorter (P<0.01) ,while no significant difference was observed between the other two groups (P>0.05). The effective rate in the combined treatment group ,the interferon treated group and the human gamma globulin treated group was 93.33% ,77.78% and 76.67% ,respectively ,with no significant differences (P>0.05). The inci‐dence rate in the combined treatment group was higher than the other groups ,but with no significant differences (P>0.05) . Conclusion Combination of interferon and gamma globulin has better clinical effect than exclusive use in treatment of HFMD combined with viral encephalitis ,with shorter disease course and tolerable adverse effects.%目的：观察丙种球蛋白及干扰素在治疗小儿手足口病（H FM D ）并发病毒性脑炎的临床疗效、症状改善状况及安全性。方法选取我院2012‐12—2013‐12收治的手足口病并发病毒性脑炎患儿87例为研究对象，随机分为3组，丙种球蛋白组30例，连续5 d静滴人血丙种球蛋白，剂量1 g／（kg・d）；干扰素组27例，采用肌内注射重组人干扰素80μg／（次・d），持续3 d ；联合组30例，采取丙种球蛋白和干扰素联合治疗。3组患儿在降颅压、退热、预防细菌感染、营养脑细胞等治疗和护理方式上均相同，观察3组患儿1周内临床症状改善情况，对比临床疗效及安全性。结果3组在生理指标恢复时间上差异无统计学意义（P＞0.05），在热程、疱疹消失时间和神经系统病理征转阴时间上差异有统计学意义，联用组所需时间显著少于干扰素组和丙种球蛋白组（P＜0.01），干扰素组和丙种球蛋白组间无显著性差异（P＞0.05）；联用组有效率（93.33％）大于干扰素组（77.78％）和丙种球蛋白组（76.67％），但两两比较差异无统计学意义（ P＞0.05）；联用组不良反应发生率高于干扰素组和丙种球蛋白组，但3组间差异无统计学意义（P＞0.05）。结论小儿手足口病并发病毒性脑炎采用丙种球蛋白联合干扰素治疗的效果较单独使用明显，缩短了病程，且不良反应可耐受，具有一定临床意义。