不同剂量丙种球蛋白治疗儿童病毒性脑炎临床疗效分析

Analysis of clinical efficacy of intravenous different dosage immunoglobulin in viral encephalitis of children

目的观察静脉滴注不同剂量丙种球蛋白(IVIG)治疗儿童病毒性脑炎的临床疗效。方法70例儿童病毒性脑炎分为大剂量IVIG治疗组(HD-IVIG)、中剂量IVIG治疗组(MD-IVIG)和对照组,HD-IVIG组在对照组常规治疗的基础上静脉滴注大剂量IVIG[400mg/(kg.d),连用5d],MD-IVIG组在对照组常规治疗的基础上静脉滴注中剂量IVIG[200mg/(kg.d),连用3d]并观察患儿的临床症状、体征消失的时间以及后遗症的发生率。结果HD-IVIG组及MD-IVIG组在急性期症状(抽搐、意识障碍、发热等)的改善方面明显优于对照组(P<0.05或P<0.01),而两治疗组间比较差异无统计学意义(P>0.05);治疗后3个月评估预后,大剂量IVIG组分别与中剂量IVIG组及对照组比较后遗症的发生率,差异均有统计学意义(P<0.05或P<0.01),中剂量IVIG组与对照组比较后遗症的发生率差异无统计学意义(P>0.05)。结论IVIG治疗儿童病毒性脑炎能减轻急性期症状,缩短病程,临床疗效好;大剂量IVIG治疗病毒性脑炎还能减轻脑组织损害,改善预后,减少后遗症的发生率。

Objective To evaluate the clinical efficacy of intravenous different dosage immunoglobulin in viral encephalitis of children. Methods Seventy children with viral encephalitis were divided into three groups in random. Besides, the two trial groups were treated with high dosage IVIG [400mg/（kg·d） ,for 5 days ] and moderate dosage IVIG [ 200mg/（ kg· d）, for 3 days ] respectively,while the control group was treated with conventional therapy only. Compared the therapeutic effect group to group. Results Both the trial group were better than the control group in improving the acute symptoms（ P 〈 0.05 or P 〈 0.01 ） , while the difference between the two trial group was not significant （ P 〉 0.05）. The sequela rate of the HD - IVIG group was lower than the other two groups（ P 〈 0.05） , while the difference between the MD - IVIG group and the control group was not significant（ P 〉 0.05）. Conclusion IVIG can improve the acute symptoms and＇high dosage of IVIG can lower the sequela rate of children viral encephalitis.