雾化吸入重组人干扰素α1b对重症手足口病早期的治疗作用

Therapeutic effect of nebulized human recombinant interferon α1b on severe hand-foot-mouth disease children with early study of nervous system complications

目的 评价雾化吸入重组人干扰素α1b对重症手足口病（神经系统受累期）患儿的疗效和安全性,为儿科合理用药提供科学依据.方法 采用随机、对照、多中心的设计方法,将3家医院重症手足口病患儿分为2组.对照组采用常规对症治疗,治疗组在此基础上雾化吸入重组人干扰素α1b注射液30 μg/次,2次/d,疗程5～7 d.并采用SPSS 17.0软件进行分析,比较2组患儿疗效.结果 2013年5至11月共66例患儿入组,与对照组比较,雾化吸入重组人干扰素α1b可显著缩短重症手足口病（神经受累期）患儿热程[治疗组（1.9±1.1）d,对照组（2.7±1.2）d,P＜0.05]、恢复进食时间[治疗组（3.9±1.4）d,对照组（4.9±1.6）d,P ＜0.05]和中枢神经系统症状持续时间[治疗组（2.6±1.1）d,对照组（3.2±1.0）d,P＜0.05],明显缓解易惊[治疗组（2.4±1.0）d,对照组（3.2±0.9）d,P＜0.05]和肢体抖动[治疗组（2.0±1.1）d,对照组（2.9±1.2）d,P＜0.05]的持续时间.对治疗组用药期间生命体征、血常规、血生化的观察和检查均未见不良反应.结论 雾化吸入人重组干扰素α1b可用于治疗小儿手足口病,能显著改善重症手足口病早期患儿的神经系统表现和其他临床表现,安全性良好.

Objective To evaluate the efficacy and safety of nebulized recombinant human interferon α1b （IFN-α1b） for severe hand-foot-mouth disease （HFMD）children with central nervous system complications （CNSC）.Methods This was a multi-center,prospective,cohort study.Severe HFMD children with CNSC from 3 hospitals were assigned to the control group with conventional therapy,and therapeutic group based on convetional therapy with nebulization of recombinant human IFN-α1 b,30 μg twice each day,for 5-7 days.The curative effect between 2 groups was compared by using SPSS 17.0 software.Results Sixty-six cases were enrolled from May to November 2013.Compared with conventional tberapy,the treatment of nebulized IFN-α1 b could significantly reduce the duration of fever[treatment group （1.9 ± 1.1） d vs control group （2.7 ± 1.2） d,P 〈 0.05],the recovery time of food intake [treatment group （3.9 ± 1.4） d vs control group （4.9 ± 1.6） d,P 〈 0.05] and the duration of the central nervous system syndrome [（2.6 ± 1.1） d vs （3.2 ± 1.0） d,P 〈 0.05],especially shorten the duration of convulsion [treatment group （2.4 ± 1.0） d vs control group （3.2 ± 0.9） d,P 〈 0.05] and myoclonic jerk [（2.0 ± 1.1） vs （2.9 ± 1.2） d,P 〈 0.05].Vital signs,routine hematological and biochemical parameters were monitored and no adverse effect was observed during the treatment.Conclusion Nebulization of human recombinant IFN-α1 b can significantly and safely alleviate early clinical syndrome of severe HFMD children.