丙种球蛋白联合甲泼尼松龙治疗小儿吉兰-巴雷综合征呼吸肌麻痹的临床研究

A clinical study of globulin combined with Methylprednisolone in treating Guillain-Barre syndrome complicated with respiratory muscle paralysis

目的：研究丙种球蛋白联合甲泼尼松龙治疗小儿吉兰～巴雷综合征（GBS）呼吸肌麻痹的临床疗效，企为临床治疗此病提供更有效的方法。方法：从在我院进行治疗的小儿GBS呼吸肌麻痹患者中，选取64例患者，并签订知情协议书。按照是否具有使用丙种球蛋白治疗的经济能力将患者分为实验组和对照组。实验组使用丙种球蛋白联合甲泼尼松龙治疗，对照组单纯使用甲泼尼松龙治疗，分别观察两组患者的休斯（Hughes）评分、疗效和不良反应。结果：试验组患者治疗的有效率为94％，显著高于对照组的690（P=0．010）；在患者接受治疗后15d，试验组患者的Hughes评分是（2．69±1．23）分，明显低于对照组患者（3．34±0．85）分（P=0．017），且在患者接受治疗后6个月时，实验组患者的Hughes评分是（1．29±0．94）分，亦明显低于对照组患者的（1．87±0．76）分（P=0．028）；实验组不良反应的发生率为16％，而对照组不良反应的发生率为220（P=0．522），差异不具有统计学意义。结论：与单纯使用甲泼尼松龙治疗小儿GBS呼吸肌麻痹相比，使用丙种球蛋白联合甲泼尼松龙治疗的疗效更为显著，且安全性较高，有利于患者病情的早期康复。

Objective：To study the clinical efficacy of 7-globulin combined with methylprednisolone in the treatment of Guillain-Barre syndrome（GBS）complicated with respiratory muscle paralysis in chil- dren,and apply a better and more efficient method for the treatment of it. Methods.. According to whether the patient was willing to accept the therapy of 7-globulin or not,64 patients with G-BS complicated with respiratory muscle paralysis in the hospital were divided into two groups：the experiment group and the control group. One was conducted globulin combined with methylprednisolone and the other was simply methylprednisolone. Then Hughes score,cure rate were oberved and adverse reaction rate were obsewed in the two groups. Results： The cure rate in the experiment group was 94%, which was distinctly higher than that in the control group 69% （P=0. 010）. The Hughes score half month and 6 months after the treatment in the experiment group was markedly lower than that in the control group （P = 0. 017, P= 0. 028）. The adverse reaction rate was 16% in the experiment group while the adverse reaction rate in the control group was 21.88% （P=0. 522）,there was no statistical difference between the adverse rates of the two groups. Conclusion： γ-globulin combined with methylprednisolone can treat children with GBS complicated with respiratory muscle paralysis safely and effectively,and it is benefit to the early recovery of patients.