甲泼尼龙琥珀酸钠联合丙种球蛋白治疗重症IM28例

Clinical analysis of methylprednisolone sodium succinate combined with IVIG in the treatment of severe IM

目的:探讨甲泼尼龙琥珀酸钠联合丙种球蛋白(IVIG)治疗重症传染性单核细胞增多症(sIM)临床效果。方法:sIM患者56例,随机分为联合组和单一组各28例。两组均给予布洛芬口服退热、干扰素联合更昔洛韦抗病毒等一般性治疗。在此治疗基础上联合组给予静脉注射甲泼尼龙琥珀酸钠5mg/kg,1次/d,连用3d;同时联合丙种球蛋白(IVIG)1000 mg/kg,静脉注射,24h内输注完毕;单一组给予丙种球蛋白(IVIG)1000mg/kg,静脉注射,24h内输注完毕。分别于治疗后第3、7、14天比较两组体温下降、症状减轻时间和实验室检查指标恢复情况。结果:联合组体温下降时间(0.92±0.58d)、症状减轻时间(2.05±0.62d)、实验室检查指标恢复时间(4.63±0.55d)明显短于单一组(2.32±0.28d)、(4.23±0.62d)、(6.53±0.62d),两组比较差异有统计学意义(P<0.05);联合组临床疗效(96.4%)显著高于单一组(71.4%)。结论:应用甲泼尼龙琥珀酸钠联合丙种球蛋白(IVIG)治疗重症传染性单核细胞增多症(sIM)临床疗效比单一应用IVIG疗效显著,临床应用简便,经济,值得借鉴和采纳。

Objective：To investigate the clinical effects of methylprednisolone combined with gamma globulin in treatment of severe infectious mononucleosis.Methods：56patients in our hospital pediatric ward with sIM were randomly divided into the combined group and a single group,and each group has 28 cases.The two groups were given general treatment of oral ibuprofen antipyretic,interferon combined with ganciclovir antiviral.Based on the previous treatment,the combination group received intravenous injection of methylprednisolone sodium succinate5mg/kg,1times/day,for 3consecutive days,also combined with gamma globulin protein（IVIG）1000mg/kg,intravenous injection,within 24 hours.The single group was given intravenous immunoglobulin（IVIG）1000mg/kg,intravenous infusion,within 24 hours.The recovery of the two group cases was contrasted after third,seventh,fourteen treatment from decrease of body temperature,symptoms relief time and laboratory tests.The symptoms before treatment,signs and laboratory tests of the combination group and single group were no statistical significance（P〉0.05）.Results：After treatment,the body temperature drops（0.92±0.58d）,the symptom relief time（2.05±0.62d）,the laboratory tests turnaround time（4.63±0.55d）were significantly shorter than those in single group（2.32±0.28d）,（4.23±0.62d）（6.53±0.62d）（P〈0.05）,and The difference was statistically significant（P〈0.05）.The clinical efficacy of the combined group（96.4%）was significantly higher than those in single group（71.4%）.Conclusion：The clinical efficacy of methylprednisolone sodium succinate combined with gamma globulin protein（IVIG）treating severe infectious mononucleosis disease（sIM）is more significantly than that of IVIG.The clinical application is simple,economic,and it is worth using for reference.