高压氧综合治疗对病毒性脑炎患儿免疫功能及预后的影响

Effects of hyperbaric oxygen combined therapy on immune function and prognosis in children with viral encephalitis

目的观察高压氧对病毒性脑炎患儿免疫功能及预后的影响。方法选择2004年7月至2007年6月山东省沂水中心医院收治的100例病毒性脑炎患儿，分成高压氧治疗组和常规治疗组，每组50例，同时设健康对照组50例。记录2组症状、体征变化，2周后脑电图变化，随访3个月记录后遗症状，2组治疗前后分别检测CIM、CD8、CD4／CD8、IgG、IgM、IgA。结果与常规治疗组相比，高压氧治疗组症状、体征、2周后脑电图恢复较快（P〈0．01或P〈0．05），后遗症中间歇性头痛、记忆力下降者较少（P〈0．05），高压氧治疗组治疗后CD4、CD8、CD4／CD8、IgG、IgM水平均较常规治疗组和健康对照组下降（P〈0．05）。结论高压氧能缩短病毒性脑炎患儿病程，减少后遗症，但可引起患儿免疫功能抑制。

Objective To observe the dynamic changes of immune function and prognosis in children with viral encephalitis treated with hyperbaric oxygen （ HBO ）. Methods One hundred children with viral encephalitis were therapied in Yishui Central Hospital in Shangdong province and selected as subjects. They were divided into two groups：HBO treatment group（ n--50） and conventional treatment group （n = 50）. At the same time, healthy control group established （n = 50 ）. The changes of symptom, physical sign, electroencephalogram levels of CIM, CD8, CD4/CD8, IgG, IgM and IgA in the two groups before and after treatment were examined. Results Compared with conventional treatment group, the recoveries of symptom, physical sign and EEG were faster （ P 〈 0.01 or P 〈 0.05 ）, the patients with sequel such as intermittent headache and impaired memory were fewer （ P 〈 0.05 ） in HBO treatment group. After treatment, the levels of CD4,CD8,CD4/CD8, IgG and IgM were lower （ P 〈 0.05 ） in HBO treatment group than in conventional treatment group and healthy control group. Conclusions HBO can decurtate the course of infantile viral encephalitis and decrease the sequel, but can inhibit infantile immune function obviously.