鼠神经生长因子治疗手足口病合并急性弛缓性麻痹的临床随访研究

Clinical follow-up study of mouse nerve growth factor in the treatment of hand-foot-and-mouth disease combined with acute flaccid paralysis

目的探讨鼠神经生长因子治疗手足口病合并急性弛缓性麻痹的临床疗效。方法观察16例手足口病并发急性弛缓性麻痹患儿临床特点,并行脊髓和(或)颅脑MRI检查,早期给予鼠神经生长因子治疗,针对性功能锻炼,并随访3～6个月。结果 16例手足口病并发急性弛缓性麻痹患者中,单侧下肢瘫12例,双下肢瘫2例,四肢瘫1例,单侧上肢瘫1例。患儿以单侧下肢瘫为主,大部分患儿表现为轻瘫。脊髓MRI检查,病变以胸12腰1为主,可见长T1、T2异常信号。下肢瘫痪恢复较快,四肢瘫、上肢瘫恢复较慢,鼠神经生长因子治疗有效促进功能恢复。结论鼠神经生长因子促进受损的神经功能早日恢复,预后较好。

Objective To discuss the clinical efficacy of mouse nerve growth factor in the treatment of hand-foot-and-mouth disease （HFMD） combined with accurate flaccid paralysis. Methods The clinical features of 16 cases of children with HFMD combined with acute flaccid paralysis were observed, and the magnetic resonance imaging （MRI） for spinal cord and/or brain was checked. The patients were given mouse nerve growth factor and specific functional training in the forepart treatment and followed up for three to six months. Results In the 16 cases with HFMD combined with acute flaccid paralysis, there were 12 cases with unilateral lower limb paralysis, 2 cases with both lower limb paralysis, 1 case with four-limbed paralysis, and 1 case with unilateral arm paralysis. The children were of unilateral lower limb paralysis in major and all children showed paresis. MRI of spinal cord showed that lesions mainly occurred in spinal cord （T12, L1） and abnormal long signals of T1, T2 could be seen. The patients with lower limb paralysis extremity recovered faster and those with four limbs and arms paralysis recovered lower. Therefore, the treatment of mouse nerve growth factor could help the function recover effectively. Conclusion The mouse nerve growth factor can promote the function of impaired never recover and the prognosis is well.