甲基强的松龙联合丙种免疫球蛋白治疗重症手足口病的效果

Effect of methylprednisolone combined with immunoglobulin on prognosis of children with severe hand foot mouth disease

目的探讨甲基强的松龙联合丙种免疫球蛋白治疗重症手足口病患儿的效果。方法选取2016年5月至2018年4月山西省儿童医院重症手足口病患儿98例,按照随机数字表法分为联合组与对照组,每组49例。对照组行常规药物治疗,联合组在对照组治疗的基础上加用甲基强的松龙联合丙种免疫球蛋白治疗。对比两组临床疗效、免疫功能、血清降钙素(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)水平以及不良反应发生情况。结果联合组治疗总有效率(79.59%)高于对照组(51.02%),差异有统计学意义(P<0.05);联合组和对照组治疗后的免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平均较治疗前上升,且联合组上述指标改善情况优于对照组,差异有统计学意义(P<0.05);两组治疗后的PCT、CRP、WBC水平均较治疗前下降,且联合组上述指标改善情况优于对照组,差异有统计学意义(P<0.05);联合组患者总不良反应发生率(6.12%)少于对照组(20.41%),差异有统计学意义(P<0.05)。结论甲基强的松龙联合丙种免疫球蛋白能提高手足口病患儿临床疗效,提高机体免疫功能,降低血清炎症因子水平,且不良反应较少,患儿预后更好。

Objective To investigate the effect of methylprednisolone combined with immunoglobulin on prognosis of children with severe hand-foot-mouth disease.Methods A total of 98 cases of severe hand-foot-mouth disease in Shanxi Children's Hospital form May 2016 to April 2018 were selected.They were divided into combined group and control group according to the random number table method,with 49 cases in each group.The control group was treated with routine drugs,and the combined group was treated with methylprednisolone combined with gamma immunoglobulin on the basis of the treatment in the control group.The clinical efficacy,immune function,inflammatory reaction and adverse reactions were compared between the two groups.Results The total effective rate in the combined treatment group(79.59%)was higher than that in the control group(51.02%),and the difference was significant(P<0.05).The levels of immunoglobulin G(IgG),immunoglobulin A(IgA)and immunoglobulin M(IgM)after treatment in the combined group and the control group were all higher than those before the treatment,and the improvement of the above indexes in the combined group were better than those in the control group,the differences were significant(P<0.05).After treatment,the levels of CT,CRP and WBC in the two groups were significantly lower than those before treatment,and the improvement of the above indexes in the combined group were better than those in the control group,the differences were significant(P<0.05);the incidence of total adverse reaction(6.12%)in the combined group was less than that in the control group(20.41%),and the difference was significant(P<0.05).Conclusions Methylprednisolone combined with immunoglobulin can improve the clinical efficacy on children with hand-foot-mouth disease,which can improve the immune function of the body,reduce the inflammatory response,and have less adverse reactions,and the prognosis of the children is better.