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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (6): 637-640.DOI: 10.3969/j.issn.1671-2587.2019.06.022

• 临床检验 • 上一篇    下一篇

IVIG联合抗病毒方案对手足口病合并脑炎患儿病程及实验室指标的影响*

王丹丹   

  1. 221000 徐州医科大学附属徐州儿童医院临床学院
  • 收稿日期:2018-11-22 出版日期:2019-12-20 发布日期:2019-12-25
  • 作者简介:王丹丹（1986-）,女,江苏徐州人,本科,主治医师,主要从事儿童临床感染性疾病研究,（Tel）18112217927。
  • 基金资助:
    * 本课题受江苏省妇幼健康科研项目（No.F201355）资助

Effect of IVIG Combined Antiviral Regimen on Disease Duration and Laboratory Parameters in Hand Foot Mouth Disease Children with Encephalitis

WANG Dan-dan   

  1. Clinical College of Xuzhou Children's Hospital Affiliated to Xuzhou Medical University 221000
  • Received:2018-11-22 Online:2019-12-20 Published:2019-12-25

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摘要： 目的 研究静脉注射用丙种球蛋白（intravenous immunoglobulin for intravenous injection,IVIG）联合抗病毒方案对手足口病（hand foot and mouth disease,HFMD）合并脑炎患儿病程及实验室指标的影响。方法 选取2016年3月~2018年1月本院收治的126例HFMD合并脑炎患儿,采用随机数字表法分为对照组及观察组,每组63例。对照组给予抗病毒治疗,观察组在对照组基础上给予IVIG治疗,疗程3~5天。观察两组患儿的实验室指标变化、病程变化及临床疗效情况。结果 两组患儿在年龄、性别、病程、儿童类型、居住地等方面差异无统计学意义（P>0.05）。两组患儿在治疗前血清碱性磷酸酶（alkaline phosphatase,ALP）、前白蛋白（prealbumin,PA）、白细胞计数（white blood cell count,WBC）、C-反应蛋白（C-reactive protein,CRP）、S100B、神经元特异性烯醇化酶（neuro specific enolase,NSE）及脑脊液S100B、NSE比较差异无统计学意义（P>0.05）,治疗后两组患儿ALP、PA均略有增高,观察组略高于对照组但差异无统计学意义（P>0.05）,血清WBC、CRP、血清S100B、血清NSE及脑脊液S100B、脑脊液NSE均有所下降且观察组明显低于对照组,差异有统计学意义（P<0.05）。观察组患儿退热时间、皮疹消退时间、神经系统症状消失时间均明显短于对照组,差异有统计学意义（P<0.05）。对照组总有效率为77.78%,观察组总有效率为96.82%,两组患儿临床疗效有效率差异有统计学意义（P<0.05）。结论 IVIG联合抗病毒治疗方案能够改善手足口病合并脑炎患儿的实验室指标,缩短各种临床症状的改善时间和病程,临床效果显著。

关键词: 静脉注射用丙种球蛋白, 手足口病, 脑炎

Abstract: Objective To investigate the effect of intravenous immunoglobulin for intravenous injection （IVIG） combined with antiviral regimen on the course and laboratory parameters of children with hand-foot-and-mouth disease （HFMD） complicated with encephalitis. Methods A total of 126 children with HFMD and encephalitis who were treated in our hospital from March 2016 to January 2018 were randomly divided into the control group and the observation group,with 63 cases in each group. The control group was given antiviral therapy,and the observation group was given IVIG on the basis of the control group for 3-5 days. The changes of laboratory indexes,course changes and clinical efficacy were observed in the two groups. Results There were no significant differences in age,gender,disease duration,child type,and place of residence between the two groups （P>0.05）. Beforetreatment,serum alkaline phosphatase （ALP）,prealbumin （PA）,white blood cell count （WBC）,C-reactive protein （CRP）,there was no significant difference between two groups in S100B,Neurospecific Enolase （NSE） and cerebrospinal fluid S100B and NSE （P>0.05）. After treatment,ALP and PA increased slightly in both groups. The group was slightly higher than the control group but the difference was not statistically significant （P>0.05）. WBC,CRP,serum S100B,serum NSE and cerebrospinal fluid S100B,cerebrospinal fluid NSE decreased,and the observation group was significantly lower than the control group. Academic significance （P<0.05）. The time of fever,rash regression time and recovery time of nervous system symptoms in the observation group were significantly shorter than the control group,and the difference was statistically significant （P<0.05）. The total effective rate was 77.78% in the control group and 96.82% in the observation group. The difference in clinical efficacy between the two groups was statistically significant （P<0.05）. Conclusion IVIG combined with antiviral treatment can improve the laboratory indicators of children with Hand-foot-mouth disease disease and encephalitis,shorten the recovering time and course of various clinical symptoms,and the clinical effect is remarkable.

Key words: Intravenous gamma globulin, Hand-foot-mouth disease, Encephalitis

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