静注人免疫球蛋白联合更昔洛韦治疗病毒性脑膜炎及对T细胞亚群及细胞因子水平的影响

Efficacy of intravenous injection of human immunoglobulin combined with Ganciclovir in the treatment of viral meningitis and its influence on T cell subsets and cytokine levels

目的研究静注人免疫球蛋白联合更昔洛韦治疗病毒性脑膜炎的疗效及对T细胞亚群及细胞因子水平的影响。方法 60例病毒性脑膜炎患者,按随机数字表法分为观察组和对照组。两组均给予抗病毒、降颅压、维持水电解质平衡、降温、止惊等对症治疗。对照组无静注人免疫球蛋白和更昔洛韦治疗措施。观察组加用静注人免疫球蛋白和更昔洛韦治疗方式。结果观察组总有效率(96.67%)高于对照组总有效率(73.33%),差异有统计学意义(P<0.05)。治疗14 d后,观察组T细胞亚群CD3+、CD8+水平分别为(47.16±4.23)、(1.56±0.23),高于对照组(43.97±4.51)、(1.38±0.24),差异有高度统计学意义(P<0.01)。治疗14 d后,观察组T细胞亚群CD4+水平(30.21±2.23)低于对照组(31.64±2.34),差异有统计学意义(P<0.05)。治疗14 d后,观察组患者白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平分别为(1.73±1.09)、(18.25±11.27)ng/L,低于对照组[(4.27±2.14)、(47.83±12.39)ng/L],差异均有统计学意义(P<0.05)。两组患者在治疗后均无肝肾功能及血液系统的损害。结论静注人免疫球蛋白联合更昔洛韦治疗病毒性脑膜炎疗效可靠,副作用小,可改善患者的IL-1、TNF-α等细胞因子水平,而且还可改善患者的T细胞亚群(CD3+、CD4+、CD8+)水平。

Objective To study the efficacy of the intravenous injection of human immunoglobulin combined with Gan- ciclovir in the treatment of viral meningitis and its influence on T cell subsets and cytokine levels. Methods 60 pa- tients with viral meningitis were divided into the observation group and the control group according to the random number table. Both groups were given anti-viral and intracranial pressure reducing, water and electrolyte balance maintaining, cooling, convulsion ceasing and other symptomatic treatment. The control group was not given the intra- venous injection of human immunoglobulin and Ganciclovir treatment, while the observation group was given the intra- venous injection of human immunoglobulin and Ganciclovir treatment. Results The total effective rate was 96.67% in the observation group, which was higher than the 73.33% of the control group, with statistically significant difference （P 〈 0.05）. After 14 days of treatment, the subset CD3＋ and CD8＋ levels of T-cell were （47.16±4.23） and （1.56±0.23） in the observation group, which were higher than the （43.97±4.51） and （1.38±0.24） in the control group, with statisti- cally significant differences （P 〈 0.05）. After 14 days of treatment, the subset CD4＋ level of T-cell was （30.21±2.23） in the observation group, which was higher than the （31.64±2.34） of the control group, with a statistically significant differ- ence （P 〈 0.05）. After 14 days of treatment, the IL-1 and TNF-α levels were （1.73±1.09） ng/L and （18.25±11.27） ng/L in the observation group, which were lower than the （4.27±2.14） ng/L and （47.83±12.39） ng/L in the control group, with statistically significant differences （P 〈 0.05）. After treatment, there was no liver and kidney function or blood system damage in either group. Conclusion The intravenous injection of human immunoglobulin combined with Ganciclovir has reliable efficacy and few side effects, can improve the IL-1, TNF-α and other cytokines levels, and can also im- prove the subset （CD3＋, CD4＋ and CD8＋） levels of T-cell.