免疫球蛋白治疗手足口病合并弛缓性瘫痪的临床疗效

Clinical Efficacy of Immunogiobin in the Treatment of Hand Foot and Mouth Disease Complicating with Acute Flaccid Paralysis

目的:观察静脉注射人血免疫球蛋白(IVIG)治疗重症手足口病(HFMD)合并急性弛缓性瘫痪(AFP)的疗效。方法:46例重症HFMD合并AFP患儿按随机抽签法分为治疗组与对照组,各23例。在均接受干扰素、甘露醇、甲泼尼龙琥珀酸钠及对症支持等治疗的基础上,治疗组同时给予IVIG治疗,2 g/(kg·d)×5 d。对两组患儿体温、瘫痪肢体肌力、精神状况、皮疹情况进行比较。结果:治疗组与对照组的治愈率分别为52.17%、17.39%(P<0.05)。治疗组与对照组的发热持续时间分别为(1±0.97)d、(3±1.08)d,精神恢复时间分别为(3±1.09)d、(5±2.74)d,患肢肌力恢复时间分别为(72±12.22)d、(119±15.05)d,三大主要症状治疗组均较对照组显著缩短(P<0.05)。结论:IVIG治疗重症HFMD合并AFP,能减轻患者症状、缩短病程、改善预后。

OBJECTIVE： To observe therapeutic efficacy of immunoglobin （IVIG） in the treatment for severe hand foot and mouth disease （HFMD） complicating with acute flaccid paralysis （AFP）. METHODS： 46 cases of severe HFMD complicating with AFP were randomly divided into treatment group and control group with 23 cases in each group. Both groups received interferon, mannitol, methylprednisolone sodium succinate and supporting treatment; treatment group was additionally treated with IVIG, 2 g/（kg, d）× 5 d. The clinical efficacies were compared between 2 groups, including body temperature, muscle strength of paralysis of limbs, spiritual state and rash. RESULTS： The cure rates of treatment group and control group were 52.17% and 17.39% （P〈 0.05）. The duration of fever were （1 ± 0.97） d and （3± 1.08） d; the time of spiritual state recovery were （3 ± 1.09） d and （5 ± 2.74） d; the time of muscle strength recovery were （72 ± 12.22） d and （119 ± 15.05） d, respectively. The duration of the main symptoms in treatment group was shorter than in control group （P〈0.05）. CONCLUSIONS： IVIG may play important roles in relieving symptoms, shortening course, and improving the prognosis in children with severe HFMD complicating with AFP.