糖皮质激素对单纯疱疹病毒性脑炎疗效及预后影响

Influence of Glucocorticoid on the incidence and prognosis of herpes simplex virus encephalitis

目的探讨糖皮质激素治疗对单纯疱疹病毒性脑炎疗效及预后的影响。方法选取2008-07—2013-07于我院临床确诊为单纯疱疹病毒性脑炎的62例患者,在常规综合治疗的基础上,根据是否加用糖皮质激素治疗,将其随机分为观察组和对照组各31例,治疗4周后观察并比较2组患者各项主要临床指标及治疗效果。结果治疗后2组患者在简易精神状态量表(MMSE)评分、颅内压异常、脑脊液白细胞数、脑脊液蛋白质定量、脑膜刺激征阳性、脑电图异常、颅脑CT异常和病程长短等方面与治疗前比较均明显改善,差异有统计学意义(P<0.05),观察组较对照组改善更明显,差异有统计学意义(P<0.05)。治疗4周后,观察组总有效率为87.10%,高于对照组的70.98%,差异有统计学意义(P<0.05)。结论糖皮质激素治疗单纯疱疹病毒性脑炎疗效肯定,临床应用要合理选择。

Objective To investigate the influence of Glucocorticoid on incidence and prognosis of herpes simplex virus en-cephalitis ,and provide new ideas for the treatment.Methods Sixty-two patients diagnosed as herpes simplex virus encephalitis in our hospital from July 2008 to July 2013 were chosen as the subjects. Based on the conventional treatment ,according to whether treatment with corticosteroids ,they were randomly divided into the observation group and control group ,31 patients in each group.After 4 weeks of treatment ,the main clinical parameters and therapeutic efficacy of the two groups were ob-served and compared. Results After treatment ,Mini-Mental State Examination （MMSE） score ,intracranial abnormalities , white blood cell count in CSF ,cerebrospinal fluid protein quantification ,positive cases of meningeal irritation ,abnormal EEG , brain CT abnormal and other aspects of disease duration were significantly improved compared with those before treatment （P〈0.05） ,but the observation group improved more significantly than the control group ,there was a significant difference （P〈0.05）. After glucocorticoid treatment for 4 weeks ,the total effective rate of observation group was 87.10% ,and was higher than 70.98% of the control group（P〈0.05） ,the differean was statistically significant.Conclusion Glucocorticoid for herpes＆amp;nbsp;simplex virus encephalitis is effective ,it should be a reasonable choice for clinical applications.