甲基强的松龙冲击治疗重症病毒性脑炎的疗效观察

Curative effect of methylprednisolone pulse therapy on children with severe viral encephalitis

目的探讨甲基强的松龙(MP)冲击疗法治疗重症病毒性脑炎(VE)患儿疗效及对血清C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)水平的影响。方法选取2016-02—2019-11就诊的重症VE患儿68例,随机分为试验组与对照组各34例。2组均进行一般治疗,对照组采用纳洛酮及神经节苷脂治疗,试验组在该基础上使用MP冲击疗法。比较2组治疗效果、临床特征消失时间、血清指标水平变化、不良反应。结果治疗后试验组总有效率为91.51%,高于对照组的73.58%(P<0.05);试验组各类临床症状消失时间早于对照组(P<0.05);试验组CRP、PCT、TNF-α、中枢神经特异性蛋白(S-100β)、人可溶性血管细胞黏附因子(sVCAM-1)、神经烯醇化酶(NSE)含量均低于对照组(P<0.05)。2组不良反应发生率比较无显著差异(P>0.05)。结论MP冲击疗法治疗重症VE患儿具有更好的临床效果,并显著降低血清炎症因子水平。

Objective To explore the curative effect of methylprednisolone(MP)pulse therapy on children with severe viral encephalitis(VE)and its influences on levels of serum C-reactive protein(CRP),procalcitonin(PCT)and tumor necrosis factorα(TNF-α).Methods A total of 68 children with severe VE who were treated from February 2016 to November 2019 were enrolled.They were randomly divided into experimental group and control group,34 cases in each group.Both groups underwent general treatment.On this basis,control group was treated with naloxone and ganglioside,while experimental group was treated with MP pulse therapy on basis of control group.The curative effect,disappearance time of clinical features,changes in levels of serum indexes,and adverse reactions were compared between the two groups.Results After treatment,the total response rate of experimental group was higher than that of control group(91.51%vs 73.58%)(P<0.05).The disappearance time of clinical symptoms in experimental group was earlier than that in control group(P<0.05).The contents of CRP,PCT,TNF-α,soluble protein-100β(S-100β),human soluble vascular cell adhesion molecule-1(sVCAM-1)and neuroenolase(NSE)in experimental group were all lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The clinical curative effect of MP pulse therapy is better on children with severe VE,which can significantly reduce the levels of serum inflammatory factors.