免疫球蛋白联合匹多莫德和利巴韦林治疗儿童重症手足口病的临床研究

Clinical study on immunoglobulin combined with pidotimod and ribavirin in treatment of children with severe hand-foot-mouth disease

目的探讨免疫球蛋白联合匹多莫德和利巴韦林治疗儿童重症手足口病的临床疗效。方法选取2013年1月—2015年1月秦皇岛市第三医院收治的重症手足口病患儿100例,随机分成对照组和治疗组,每组50例,对照组患儿静脉滴注利巴韦林注射液,10 mg/kg,1次/d;口服匹多莫德口服液400 mg/次,1次/d。治疗组在对照组的基础上,静脉滴注静注人免疫球蛋白(pH4),1.5 m L/kg,1次/d。两组均连续治疗7 d。观察两组的临床效果,比较患儿发热消退、口腔溃疡消退、皮疹消退及痊愈时间,同时比较血清肌酸激酶(CK)和C反应蛋白(CRP)水平的变化。结果治疗后,对照组和治疗组的总有效率分别为80.00%、100.00%,差异有统计学意义(P<0.01);治疗组患儿的发热消退时间、口腔溃疡消退时间、皮疹消退时间、痊愈时间均显著短于对照组患儿,两组比较差异有统计学意义(P<0.01)。治疗后,两组患儿CK和CRP均明显降低,同组治疗前后差异有统计学意义(P<0.01)。结论免疫球蛋白联合匹多莫德和利巴韦林治疗儿童重症手足口病具有良好的临床疗效,具有一定的临床推广应用价值。

Objective To investigate the curative effect of immunoglobulin combined with pidotimod and ribavirin in treatment of children with severe hand-foot-mouth disease. Methods Children（100 cases） with severe hand-foot-mouth disease in Qinhuangdao Third Hospital from January 2013 to January 2015 were enrolled in this study. According to different treatment plans the patients were divided into control（50 cases） and treatment（50 cases） groups. Patients in the control group were iv administered with Ribavirin Injection, 10 mg/kg, once daily, and were po administered with Pidotimod Oral Solution, 400 mg/time, once daily. Patients in the treatment group were iv administered with Human Immunoglobulin（p H4） for iv injection on the basis of control group, 1.5 m L/kg, once daily. The patients in two groups were treated for 7 d. The clinical efficacy in two groups was evaluated, the subsided time of fever, oral ulcer, skin rash, recovery time, changes of CK and CRP levels were compared in two groups before and after treatment. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 100.00%, respectively, and there were differences between two groups（P〈0.01）. After treatment, the subsided time of fever, oral ulcer, skin rash, and recovery time in treatment group were lower than those in the control group, the difference was statistically significant（P〈0.01）. The CK and CRP levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. difference was statistically significant in the same group（P〈0.01）, and there was no difference between two groups. Conclusion Immunoglobulin combined with pidotimod and ribavirin in treatment of children with severe hand-foot-mouth disease has good curative effect, which has a certain clinical application value.