神经节苷脂联合干扰素治疗小儿病毒性脑炎的疗效观察

Observation on the curative effect of ganglioside combined with interferon in treatment of pediatric viral encephalitis

目的探讨神经节苷脂联合干扰素治疗小儿病毒性脑炎(VE)的疗效,以期为小儿VE的干预治疗提供更加充分的临床依据。方法选取2016年6月-2018年6月丽水市中心医院收治的VE患儿83例。依据患儿实际情况、家长治疗意愿结合随机分配原则,分为对照组(40例)和观察组(43例)。治疗过程中,对照组有3例,观察组有2例退出临床观察。对照组给予常规治疗,观察组在对照组基础上给予神经节苷脂和干扰素治疗。疗程10d。比较两组患儿临床症状改善、住院时间、临床疗效,实验室指标、不良反应及后遗症发生情况等。结果治疗后,观察组的治疗总有效率显著高于对照组,差异有统计学意义(P<0.05);患儿退热时间、抽搐停止时间、意识障碍改善时间、脑膜刺激征消失时间、住院时间均明显短于对照组,差异有统计学意义(均P<0.05);观察组降钙素基因相关肽(CGRP)较对照组升高更显著,差异有统计学意义(P<0.05),肿瘤坏死因子-α(TNF-α)、髓磷脂碱性蛋白(MBP)、血清S100B蛋白及神经生长因子(NGF)较对照组降低更显著,差异有统计学意义(均P<0.05);两组患儿均未出现严重不良反应;观察组后遗症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论神经节苷脂联合干扰素治疗小儿VE,能明显改善患儿临床症状,提高患儿免疫力,减少后遗症发生率。

Objective To explore the curative effect of ganglioside combined with interferon in treatment of pediatric viral encephalitis, provide more sufficient clinical basis for intervention and treatment of pediatric viral encephalitis. Methods Eighty-three children with viral encephalitis treated in Lishui Central Hospital from June 2016 to June 2018 were selected and divided into control group ( 40 children) and observation group ( 43 children) according to the actual situation of children and willingness of parents. In the course of treatment,three pa- tients in control group and two patients in observation group were lost to follow-up. The patients in control group were treated by routine ther-apy,and the patients in observation group were treated by ganglioside combined with interferon based on routine therapy,the patients in the two groups were treated for 10 days. The improvement time of clinical symptoms,hospitalization time,clinical effects,laboratory indexes, adverse reactions,and incidence rates of sequelae in the two groups were compared. Results After treatment,the total effective rate in observation group was statistically significantly higher than that in control group ( P<0. 05). The disappearance time of fever and convulsion, improvement time of consciousness disturbance,disappearance time of meninges stimulation sign,and hospitalization time in observation group were statistically significantly shorter than those in control group ( P<0. 05). The level of calcitonin generelated peptide ( CGRP) in observation group was statistically significantly higher than that in control group ( P<0. 05). The levels of tumor necrosis factor-α( TNF-α),myelin basic protein ( MBP),serum S100B protein,and neuron growth factor ( NGF) in observation group were statistically significant- ly lower than those in control group ( P<0. 05). No severe adverse reaction was found in the two groups. The total incidence rate of sequel- ae in observation group was statistically significantly lower than that in control group ( P<0. 05). Conclusion Ganglioside combined with interferon can significantly improve clinical symptoms and immunity,reduce the incidence rate of sequelae of children with pediatric viral en- cephalitis.