甲基泼尼松龙联合米力农注射液对手足口病合并脑炎患儿的疗效研究

Efficacy of Methylprednisolone Combined with Milrinone Injection in Treating Children with Hand-foot-mouth Disease Complicated with Encephalitis

目的探讨甲基泼尼松龙联合米力农注射液在手足口病(HFMD)合并脑炎患儿临床治疗中的实际疗效与安全性。方法以该院于2015年1月—2017年12月收治的78例HFMD合并脑炎患儿作为研究样本,将其分为对照组与观察组各39例,对照组采用常规单独米力农注射液治疗方案,观察组采用米力农注射液联合甲基泼尼松龙治疗方案,记录两组的临床症状消失时间,并于治疗5 d后对比两组的临床总有效率,同时对比治疗前后两组免疫功能IgA、IgC、IgM、CD3和CD4指标变化情况,最后观察两组用药期间不良反应的发生情况。结果①观察组临床总有效率为94.87%,明显高于对照组74.36%(χ^2=6.303,P<0.05)。②观察组的意识模糊、发热、意识模糊、血压异常、面色苍白、脉搏减弱症状消失时间分别为(3.29±0.38)、(6.39±0.92)、(1.23±0.15)、(4.04±0.76)、(2.34±0.41)、(4.12±0.63)d,均明显低于对照组(t=15.374、8.354、18.932、11.585、19.606、17.412,P<0.05)。③治疗前,两组各项免疫功能指标之前比较差异无统计学意义(P>0.05);治疗后,观察组的IgA、IgC、IgM、CD3和CD4水平分别为(2.55±0.62)g/L、(13.15±3.71)g/L、(2.64±0.51)g/L、(0.67±0.08)、(0.48±0.04),均明显优于对照组,差异有统计学意义(t=3.268、3.724、3.891、9.992、8.778,P<0.05)。④用药期间,观察组的不良反应发生率为10.26%,两组之间比较差异无统计学意义(χ^2=1.216,P>0.05)。结论甲基泼尼松龙联合米力农注射液治疗HFMD合并脑炎患儿的疗效确切,能够迅速纠正临床症状,效改各项免疫功能,而且不会明显提高不良反应发生率,安全性较高。

Objective To evaluate the efficacy and safety of methylprednisolone combined with milrinone injection in the treatment of children with HFMD complicated with encephalitis. Methods A total of 78 children with HFMD from January 2015 to December 2017were divided into control group (39 cases) and observation group (39 cases). The control group was treated with conventional milrinone injection alone, while the observation group was treated with milrinone injection combined with methylprednisolone. The time of the disappearance of clinical symptoms was recorded and the total effective rate of the two groups were compared after 5 days of treatment. The changes of IgA, IgC, IgM, CD3 and CD4 were compared before and after treatment. Results 1.The total clinical effective rate of the observation group was 94.87%, which was significantly higher than that of the control group 74.36%(χ^2=6.303, P<0.05).2.The time of disappearance of confusion, fever, confusion, abnormal blood pressure, pale complexion, and weakened pulse in the observation group were (3.29±0.38)d,(6.39±0.92) d,(1.23±0.15) d,(4.04±0.76) d,(2.34±0.41) d,(4.12±0.63) d, respectively, which were significantly lower than those of the control group (t=15.374, 8.354, 18.932, 11.585, 19.606, 17.412, P<0.05).3.Before treatment, there was no significant difference in the immune function indexes between the two groups (P>0.05). After treatment, the levels of IgA, IgC, IgM, CD3 and CD4 in the observation group (2.25±0.62)g/L,(13.15±3.71)g/L,(2.64±0.51)g/L,(0.67±0.08),(0.48±0.04) were significantly higher than those in the control group (t=3.268, 3.724, 3.891, 9.992, 8.778, P<0.05).4.The incidence of adverse reactions in the observation group was 10.26%, and there was no statistical significance between the two groups (χ^2=1.216,P>0.05). Conclusion Methylprednisolone combined with milrinone injection is effective in the treatment of children with HFMD complicated with encephalitis. It can quickly restore clinical symptoms, improve various immune functions, and will not significantly increase the incidence of adverse reactions, and has high safety.