静脉注射人免疫球蛋白在急性小脑共济失调中的应用价值

Clinical Value of Intravenous Immunoglobulin in Acute Cerebellar Ataxia

目的:探讨静脉注射人免疫球蛋白治疗儿童急性小脑共济失调(ACA)的疗效及安全性。方法:选取2007年6月至2012年6月在广州市妇女儿童医疗中心神经康复科就诊并诊断为ACA的患儿61例,分为激素组39例和联合组22例,其中激素组为应用甲泼尼龙10 mg/(kg·d),5 d后每5 d减半量,至临床症状完全消失停药;联合组在激素组用药基础上加用静脉注射人免疫球蛋白400 mg/(kg·d),连用5 d,比较两组患儿症状改善情况及疗程。结果:联合组病情好转时间为(7.18±2.87)d,激素组病情好转时间为(9.95±2.92)d,两组比较差异有统计学意义(P<0.05);联合组总疗程(17.64±6.79)d,激素组总疗程(15.72±5.84)d,两组比较差异无统计学意义(P>0.05)。治疗后两组患儿眼震颤、意向震颤、语言障碍体征持续时间比较差异无统计学意义(P>0.05);闭目难立征存在时间联合组较激素组缩短(P<0.05)。结论:儿童ACA应用静脉注射人免疫球蛋白治疗能够较快改善症状,但不能缩短疗程。

Objective： To explore the clinical value of intravenous immunoglobulin in children with acute cerebellar ataxia （ACA）. Methods： Data of 61 children with ACA were analyzed from June 2007 to June 2012. They were divided into hormone group and combination group. Hormone group was treated with methylprednisolone 10 mg/（ kg · d） , cutting the dosage to half every 5 days until symptom improvement; On this basis combination group was treated with intravenous immunoglobulin 400 mg/（ kg·d） for 5 days. Compare the symptom improvement and the course of treatment. Results： The time of symptom improvement were （7.18±2.87） days in combination group and （9.95±2.92） days in hormone group （P〈0.05） , the course of treatment were （ 17.64±6.79 ） days and （ 15.72 ±5.84） days separately （P〉0.05）. After treatment, the duration of nystagmus, ntention tremor, language barrier in two groups were not statistically significant （P 〉 0. 05 ）. Conclusions： Intravenous immunoglobulin combined with hormone can quickly improve symptoms in ACA children, but can not shorten the course of treatment.