丙种球蛋白辅助治疗手足口病合并神经系统损害疗效观察

The Therapeutic Effects of Intravenous Immunoglobulin in Treating Hand-Foot-Mouth Disease Complicated by Nervous System Damage

目的:探讨丙种球蛋白(IVIG)治疗手足口病合并神经系统损害的疗效。方法:采用前瞻性研究方法,将148例手足口病合并神经系统损害患儿随机分为对照组和观察组各74例,对照组予利巴韦林10 mg/(kg·d)、小剂量甲泼尼龙2 mg/(kg·d)及20%甘露醇3 mL/kg,每6 h或每8 h1次,观察组在此基础上加用IVIG 1 g/(kg·d)治疗,共2 d,比较两组患儿在发热持续时间、神经系统症状恢复时间、病程等方面的差异。结果:对照组和观察组发热持续时间分别为(5.58±0.87)d、(4.47±1.21)d;神经系统症状恢复时间分别为(2.85±0.72)d、(2.21±1.36)d;病程分别为(6.29±1.41)d、(5.47±1.41)d。两组各项指标比较差异均有统计学意义(P<0.05)。结论:应用IVIG辅助治疗手足口病合并神经系统损害能改善患儿的临床症状、缩短病程。

Objective： To study the effects of intravenous immunoglobulin （[VIG） in treating hand-foot-mouth disease complicated by nervous system damage. Methods： By using prospective study method, 148 cases of hand-foot-mouth disease complicated by nervous system damage were randomly divided into two groups. Both group received ribavirin 10 mg/kg per day, small-dose methylpredniselone 2 mg/kg per day and 20% of mannitol 3 mL/kg, q 6 h or q 8 h. The observer group received IVIG treatment 1 g/kg per day additionally. After treatment, the time of fever duration, the recovery time of nervous system symptoms and disease course of the two groups were compared. Results： The time of fever duration in the control group and the observer group were （5.58±0.87） days and （4.47±1.21） days, respectively; the recovery time of nervous system symptoms were （2. 85±0. 72） days and （2. 21±1.36） days, respectively ; disease courses were （ 6.29±1.41 ） days and （5.47±1.41） days, respectively. The difference between the two groups was statistically significant （P 〈 0. 05 ）. Conclusions： Combining with IVIG in the treatment of hand-foot-mouth disease with neurological injury can improve symptoms and shorten the course.