重组人干扰素α-2b治疗手足口病患儿的临床及病毒学效果观察

Clinical and Virological Efficacy of Recombine Human Interferon α-2b for Hand-foot-mouth Disease in Children

目的：以利巴韦林为对照，观察重组人干扰素α-2b治疗手足口病患儿的临床效果及其对不同手足口病病毒学亚型的疗效。方法：将151例手足口病患儿以随机抽样法分为干扰素组（76例）、利巴韦林组（75例），干扰素组患儿给予肌内注射重组人干扰素α-2b50～200万IU，1日1次；利巴韦林组患儿给予静脉滴注利巴韦林10mg／kg，1日1次，观察2组的临床效果和病毒学效果。结果：干扰素组的临床有效率高于利巴韦林组（P=0．012），干扰素组患儿的退热时间、疱疹消退时间和溃疡愈合时间等显著短于利巴韦林组（P〈0．05）；病毒学效果方面，干扰素组患儿用药48h即显示出抑制病毒复制的作用，与利巴韦林组比较，Ct值差异显著（P=0．025），而且重干扰素α-2b对EV71型和高病毒滴度型手足口病患儿的疗效更加明显（P=0．001）。2组患儿均未出现不良反应。结论：肌内注射重组人干扰素α-2b治疗手足口病患儿，无论是临床效果还是病毒学效果均优于利巴韦林。

OBJECTIVE： To evaluate the clinical and virological efficacy of recombine human interferon α-2b （IFNα-2b） versus ribovirin in the treatment of hand-foot-and-mouth disease （HFMD） in children. METHODS： 151 patients with HFMD were randomly assigned to either IFNα-2b group （n =76） treated with IFNα-2h at dosage of 0. 5-2 （ 10 000 IU） q. d intramuscularly or ribovirin group （n =75） treated with ribovirin at a dosage of 10 mg/kg q. d by iv gtt. The clinical and virological efficacy was evaluated. RESULTS： IFNα-2b group showed higher clinical effective rate than in ribovirin group （P =0. 012） ; the fever clearance time, herpes clearance time and the ulcer healing time in IFNα-2b group were significantly shorter than in ribovirin group （P 〈 0. 05）. With regard to virological efficacy, IFNα- 2b group showed inhibitory effect on virus replication at 48 hours after drug administration, and the differences were significant as compared to ribovirin group in Ct value （ P =0. 025 ） ; moreover, IFNα-2b groups showed significantly higher efficacy than ribovirin group in the treatment of EV71 subgroup and high viral titer subgroup （ P = 0. 001 ）. No significant adverse drug reactions were observed for the two groups. CONCLUSION： IFNα-2b （administered intramuscularly） is superior to ribovirin in either clinical or virological efficacy in the treatment of HFMD