糖皮质激素在2期及3期重症手足口病中的应用效果

Efficacy of glucocorticoid applied to severe hand-foot-mouth disease in stage 2 or 3

目的探讨糖皮质激素在2期及3期重症手足口病中的应用效果。方法选取重症手足口病患儿246例,根据病情分为2期组(217例)和3期组(29例),每组均分为观察组和对照组两个亚组,其中观察组给予糖皮质激素治疗,而对照组未使用糖皮质激素。对比在不同分期观察组和对照组的临床症状缓解情况及临床转归。结果 2期患儿中,观察组的入院第3天WBC计数、神经系统症状缓解时间高于或长于对照组,而病情进展时间短于对照组(P<0.05),两组发热持续时间比较,差异无统计学意义(P>0.05)。3期患儿中,观察组神经系统症状缓解时间长于对照组(P>0.05),而两组发热持续时间、入院第3天WBC计数及病情进展时间比较,差异均无统计学意义(P>0.05)。不同时期观察组与对照组危重型转化率、病死率比较,差异均无统计学意义(P>0.05)。结论 2、3期重症手足口病患儿使用激素临床效果不佳。

Objective To explore the efficacy of glucocorticoid applied to severe hand-foot-mouth disease （HFMD） in stage 2 or 3. Methods A total of 246 children with severe HFMD were selected and were divided into stage 2 group （n = 217） and stage 3 group （ n = 29） according to the severity of the disease. Both groups were divided into two subgroups（observation group and control group） separately. The glucocorticoid therapy was performed in the observation group but was not performed in the control group. The clinical symptoms relief and clinical outcome were compared between the observation group and the control group in different stages. Results In the children of stage 2,the WBC count on the 3rd day of hospitalization,and the relief time of neurological symptoms were higher or longer but the time for disease progression was shorter in the observation group compared to the control group （P 〈 0.05 ）, there was no significant difference in the duration of fever between the two groups （ P 〉 0.05 ）. In children of stage 3, the relief time of neurological symptoms in the observation group was longer than that in the control group （P 〈 0.05 ）, but there were no significant differences in the duration of fever, WBC count on the 3rd day of hospitalization or time for disease progression between the two groups （P 〉 0.05）. There were no significant differences in the critical conversion rate or mortality between the observation group and the control group in different stages （P 〉 0.05 ）. Conclusion Poor clinical efficacy of glucocorticoid is observed in children with severe HFMD in stage 2 or 3.