神经节苷脂治疗重症手足口病患儿临床疗效及NSE和S-100β蛋白变化

Clinical efficacy of ganglioside on treatment of severe hand-foot-mouth disease and changes in neuron-specific enolase and S-100β protein

目的探讨神经节苷脂对重症手足口病(HFMD)患儿疗效,以及血清神经元特异性烯醇化酶(NSE)和血浆S-100β蛋白的影响。方法某院2011年4月—2014年6月收治的140例重症HFMD患儿随机分为常规治疗组和试验组,选择同期门诊体检健康儿童30例作为正常对照组。常规治疗组予以抗病毒、降颅压等治疗;试验组在常规治疗组基础上加用神经节苷脂,比较3组儿童NSE和S-100β蛋白水平,以及常规治疗组和试验组临床疗效。结果试验组总有效率为91.43%(64/70),高于常规治疗组78.57%(55/70)(χ2=4.54,P<0.05)。重症HFMD患儿NSE及S-100β蛋白分别为(17.63±4.21)μg/L、(492.05±119.33)ng/L,均高于对照组[分别为(8.79±2.12)μg/L、(296.35±91.02)ng/L](均P<0.01)。治疗前,常规治疗组和试验组患儿血清NSE、S-100β蛋白水平比较,差异均无统计学意义(均P>0.05);治疗10 d后,两组患儿血清NSE、S-100β蛋白水平均低于治疗前(均P<0.01),且试验组NSE、S-100β蛋白下降水平分别为(10.18±2.36)μg/L、(247.55±64.64)ng/L,均高于常规治疗组[分别为(5.87±3.03)μg/L、(113.97±43.44)ng/L](均P<0.01)。结论神经节苷脂对重症HFMD患儿有明显的疗效,可有效降低脑组织损伤标志物NSE及S-100β蛋白。

Objective To evaluate the efficacy of ganglioside on treatment of severe hand-foot-mouth disease （HFMD）in children,and effect on serum neuron-specific enolase （NSE）as well as plasma S-100βprotein levels.Methods One hun-dred and forty cases of severe HFMD patients in a hospital from April 2011 to June 2014 were randomly divided into routine therapy group and trial group,and 30 healthy children who received physical examination in outpatient de-partment during the same period were selected as control.Children in routine therapy group were given antiviral and intracranial decompression therapy;trial group were administered ganglioside in addition to routine therapy ,levels of NSE and S-100 βprotein levels of 3 groups,as well as clinical efficacy between routine therapy group and trial group were compared.Results Total efficacy rate of trial group was significantly higher than routine therapy group （91 .43%[64/70]vs 78.57%[55/70],χ^2 =4.54,P〈0.05）.The levels of NSE and S-100βprotein in children with severe HFMD were significantly higher than control group （[17.63±4.21）μg/L vs [8.79±2.12]μg/L;[492.05±119.33]ng/L vs [296.35±91 .02]ng/L,both P〈0.01）.NSE and S-100 βprotein levels of routine therapy group and trial group before treatment were not significantly different（both P〉0.05）;after 10-day treatment,NSE and