免疫球蛋白联合注射用甲泼尼龙琥珀酸钠冲击治疗自身免疫性脑炎患者的临床效果

Clinical Effect of Immunoglobulin Intravenous Drop Combined with Sodium Methylprednisolone Succinate in the Treatment of Patients with Autoimmune Encephalitis

目的探讨免疫球蛋白联合注射用甲泼尼龙琥珀酸钠冲击治疗自身免疫性脑炎患者的临床效果。方法选取2017年1月至2019年10月在沈阳市第一人民医院就诊的59例自身免疫性脑炎患者作为研究对象,按随机数字表法分为观察组(30例)与对照组(29例)。观察组。对照组给予甲泼尼龙琥珀酸钠冲击治疗,观察组在此基础上联合免疫球蛋白治疗。比较两组住院相关指标、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+))和炎症介质[白细胞介素-6(IL-6)、γ干扰素(INF-γ)、肿瘤坏死因子-α(TNF-α)]水平,并记录不良反应发生情况。结果观察组患者症状消失时间、精神好转时间和住院时间明显短于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)明显升高,CD8^(+)明显降低,且观察组改善程度优于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-6、INF-γ、TNF-α明显降低,且观察组明显低于对照组,差异有统计学意义(P<0.05)。观察组患者不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论对自身免疫性脑炎患者使用免疫球蛋白联合注射用甲泼尼龙琥珀酸钠冲击治疗,能明显改善患者炎症介质和免疫功能,患者症状得到更快改善,精神好转时间和住院时间短,安全性好。

Objective To investigate the clinical effect of immunoglobulin intravenous drop combined with sodium methylprednisolone succinate in the treatment of patients with autoimmune encephalitis. Method A total 59 patients with autoimmune encephalitis admitted to Shenyang First People’s Hospital from January 2017 to October 2019 were selected as the research objects and were randomly divided into an observation group(30 cases) and a control group(29 cases). The control group was treated with methylprednisolone succinate, and the observation group was treated with immunoglobulin intravenous drip plus methylprednisolone succinate. The hospital-related indicators, immune function indicators(CD3^(+), CD4^(+), CD8^(+)) and inflammatory mediators [interleukin-6(IL-6), interferon-γ(INF-γ), tumor necrosis factor-α(TNF-α)] level of the 2 groups were compared, and the occurrence of adverse reactions were recorded. Results The duration of symptom disappearance, mental improvement and hospital stay in the observation group were significantly shorter than those in the control group, with significant difference(P<0.05). After treatment, CD3^(+) and CD4^(+) of the 2 groups were significantly increased, and CD8^(+) were significantly decreased, the improvement degree of the observation group was better than that of the control group, with significant difference(P<0.05), the statistical analysis made sense. After treatment, IL-6, INF-γ and TNF-α of the 2 groups were significantly decreased, and the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05) Conclusion The application of immunoglobulin intravenous drops combined with sodium methylprednisolone succinate in patients with autoimmune encephalitis can obviously improve the level of inflammatory factors and immune factors, the symptoms of the patients were improved faster, the mental improvement time and hospital stay time were short, with good safety.