丙种球蛋白联合常规抗病毒治疗小儿病毒性脑炎疗效观察

摘要

目的 观察丙种球蛋白静滴联合常规抗病毒治疗小儿病毒性脑炎的疗效.方法 选取2015年1月至2016年12月四川大学华西第二医院收治的60例病毒性脑炎患儿,分为对照组和研究组,每组各30例.对照组行常规抗病毒与降颅压、退热等对症支持治疗;研究组在对照组的基础上,给予丙种球蛋白静滴进行联合治疗.通过全自动生化分析仪分别对两组患儿治疗前、治疗后1周的血清肌酸激酶、乳酸脱氢酶、天门冬氨酸氨基转移酶、肌酸激酶同工酶的水平进行检测与对比,并比较两组的临床疗效.结果 对照组与研究组治疗后1周的血清肌酸激酶、乳酸脱氢酶、天门冬氨酸氨基转移酶、肌酸激酶同工酶水平均低于治疗前(t值分别为24.10、10.18、12.82、17.71,均 P<0.05),且研究组均低于对照组(t值分别为 -2.84、-2.65、-3.24、-3.43,均P<0.05);研究组治疗总有效率(96.67%)明显高于对照组(83.33%),差异有统计学意义(χ2=7.34,P<0.01).结论 丙种球蛋白静滴联合常规抗病毒在治疗小儿病毒性脑炎中具有较好的临床疗效,临床上值得推广.%Objective To observe the curative effect of intravenous administration of gamma globulin combined with routine antiviral therapy in treatment of viral encephalitis in children.Methods A total of 60 children with viral encephalitis admitted to West China Second University Hospital during January 2015 to December 2016 were selected and were divided into research group and control group with 30 cases in each group.In the control group,the children were treated with routine antiviral therapy and antihypertensive therapy,antipyretic therapy and other symptomatic support therapies,while in the research group,the children accepted intravenous administration of gamma globulin besides the therapies for the control group.The levels of serum creatine kinase,lactic dehydrogenase,aspartate aminotransferase,creatine kinase isoenzyme were respectively detected and compared before and after treatment for one week by the automatic biochemical analyzer.The curative effect was compared between two groups.Results The levels of serum creatine kinase,lactate dehydrogenase,aspartate aminotransferase,creatine kinase isoenzyme in two groups after treatment for one week were lower than those before treatment(t value was 24.10,10.18,12.82 and 17.71, respectively,all P<0.05),and those levels in the research group were lower than those in the control group(t value was -2.84,-2.65,-3.24 and -3.43,respectively,all P<0.05).The overall effective rate in the research group(96.67%)was higher than that in the control group(83.33%),and the difference was statistically significant(χ2=7.34,P<0.01).Conclusion Intravenous administration of gamma globulin combined with routine antiviral therapy in treatment of viral encephalitis in children is of high clinical efficacy,so it is worthy of promotion in clinics.