丙种球蛋白与甲泼尼龙联合治疗2期手足口病

Effects of intravenous immunoglobulin combined with methylprednisolone in the treatment for the phase 2 hand-foot-mouth disease

目的探讨丙种球蛋白与甲泼尼龙联合治疗2期手足口病的临床疗效。方法收集自2013年7月至2016年12月于河北大学附属医院住院的2期手足口病患儿共有108例,其中对照组60例,每次给予甘露醇0. 5～1 g/kg脱水,利巴韦林10 mg/(kg·d)抗病毒;观察组48例,在对照组基础上加用甲泼尼龙1～2 mg/(kg·d),丙种球蛋白(总量2 g/kg,分2 d应用);比较2组治疗的临床效果以及治疗前后血NSE、S100B以及中性粒细胞百分比、IL-6、IL-10、TNF-α水平。结果与对照组比较,观察组在发热时间、皮疹消失、神经系统症状恢复等方面优于对照组,差异有统计学意义(P<0. 05)。观察组治疗后中性粒细胞百分比、NSE、S100B、IL-6、IL-10、TNF-α水平明显低于对照组。观察组总有效率高于对照组。结论应用丙种球蛋白与甲泼尼龙联合治疗重症手足口病能提高临床疗效,缩短病程,促进NSE、S100B恢复,改善免疫状态。

Objective To investigate the effects of intravenous immunoglobulin(IVIG)combined with methylprednisolone in the treatment of phase2hand-foot-mouth disease(HFMD).Methods108cases with phase2HFMD admitted into Affiliated Hospital of Hebei University from July2013to December2016were selected and treated with mannite and ribavirin in vein as basic therapy,while48cases(observation group)received IVIG combined with methylprednisolone.Results The duration of fever,rash,and the central nervous system(CNS)involvement were shorter in the observation group than that in the control group(P<0.05).After treatment,the percentage of neutrophils,the levels of serum NSE,S100B,IL-6,IL-10and TNF-αin the observation group were significantly lower than those in the control group.There was a better overall curative rate in the observation group than that in the control group(P<0.05).Conclusion IVIG combined with methylprednisolone regimen can result in a recovery of NSE,S100B.It can be helpful to shorten the sick course,improve the curative effects and the immunity function.