硫酸镁佐治重型手足口病的临床研究

The Clinical Study of Magnesium Sulphate in Treatment of Children with Severe Hand-foot-mouth Disease

目的：通过重型手足口病（HFMD）患儿静滴硫酸镁治疗前后相关因素变化的临床观察研究，为早期重症手足口病患儿硫酸镁干预治疗提供理论依据。方法：以30例重型HFMD患儿为研究对象，按照随机数字表法将其分为对照组和治疗组各15例，对照组给予常规治疗，治疗组在常规治疗基础上加用静脉滴注25%硫酸镁60-80 mg/（kg·d）。连续观察记录两组患者的心率（HR）、平均动脉压（MAP）、神经系统受累时间及住院时间。结果：所有重型HFMD患儿均治愈，两组治疗72 h后的HR、MAP水平均有不同程度降低，但两组间均无明显差异（P〉0.05），对照组治疗前后比较差异无统计学意义，而治疗组较治疗前均明显降低，差异均有统计学意义（P〈0.05）。与对照组相比，治疗组治疗72 h后神经系统受累时间较对照组明显缩短，差异有统计学意义（P〈0.05）。结论：硫酸镁能降低早期重症手足口病患儿交感神经兴奋度，可防治重型HFMD患儿进一步恶化。

Objective：To investigate clinical observation and research relevant factors changes severe HFMD children before and after intravenous infusion of Magnesium sulfate treatment,providing a theoretical basis for early magnesium sulfate intervention therapy in children with severe HFMD（hand foot and mouth disease）.Method：Thirty children who were diagnosed as severe HFMD were selected in this study.The subjects were randomly divided into the treatment group and the control group,15 cases in each group.The control group was given routine treatment based on their symptoms,the treatment group was given intravenous infusion of 25%magnesium sulfate 60-80 mg/（kg·d）on the basis of routine treatment.The HR,MAP,nervous system involvement and hospitalization time of patients in two groups were continuously observed and and recorded.Result：All children with severe HFMD were cured,the levels of HR,MAP in the two group were decreased in different degree 72 h after treatment,but there were no significant difference between the two groups（P〉0.05）,the control group had no significant difference,while the treatment group 72 h after treatment were significantly lower than before treatment,the differences were statistically significant（P〈0.05）.Compared with the control group,the CNS involvement duration in the treatment group 72 h after treatment was significantly shorter than that of control group,the difference was statistically significant（P〈0.05）.Conclusion：Early magnesium sulphate treatment can attenuate the excitation of the sympathetic nervous system,it may be useful to effectively prevent severe HFMD from further deterioration.