头部亚低温联合静注人免疫球蛋白(pH4)治疗重症病毒性脑炎患儿的效果

Effect of head mild hypothermia combined with human immunoglobulin (pH4) for intravenous injection in children with severe viral encephalitis

目的探讨头部亚低温联合静注人免疫球蛋白(pH4)治疗重症病毒性脑炎(SVE)患儿的效果。方法选取2020年6月至2021年6月本院收治的40例SVE患儿作为研究对象,按随机数字表法将其分为对照组(20例,地塞米松治疗)和观察组[20例,头部亚低温+静注人免疫球蛋白(pH4)治疗]。比较两组患儿的治疗效果。结果治疗后,两组的血清与脑脊液神经元特异性烯醇化酶(NSE)和肌酸激酶脑型同工酶(CK-BB)水平均显著降低,且观察组显著低于对照组(P<0.05)。治疗后,两组的可溶性血管细胞粘附分子-1(sVCAM-1)、髓鞘碱性蛋白(MBP)、降钙素原(PCT)水平均显著降低,且观察组显著低于对照组(P<0.05)。治疗后,两组的白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平及美国国立卫生院卒中量表(NIHSS)评分均显著降低,且观察组低于对照组(P<0.05)。治疗7 d后,两组的血清与脑脊液基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)水平均降低,且观察组显著低于对照组(P<0.05)。结论头部亚低温与静注人免疫球蛋白(pH4)联合治疗SVE的效果显著,可有效保护患儿神经元细胞,促进神经功能恢复,值得临床推广与应用。

Objective To investigate the effect of head mild hypothermia combined with human immunoglobulin(pH4)for intravenous injection in children with severe viral encephalitis(SVE).Methods A total of 40 children with SVE admitted in our hospital from June 2020 to June 2021 were selected as the research objects and divided into control group(20 cases,treated with dexamethasone)and observation group[20 cases,treated with head mild hypothermia+human immunoglobulin(pH4)for intravenous injection]according to random number table method.The treatment effects of the two groups of children were compared.Results After treatment,the levels of neuron-specific enolase(NSE)and brain typeisoenzyme of creatine phosphokinase(CK-BB)in serum and cerebrospinal fluid significantly decreased in both groups,and those in the observation group were significantly lower than the control group(P<0.05).After treatment,the soluble vascular cell adhesion molecule-1(sVCAM-1),myelin basic protein(MBP),procalcitonin(PCT)levels in both groups significantly decreased,and those in the observation group were significantly lower than control group(P<0.05).After treatment,the levels of interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and the National Institutes of Heath Stroke Scale(NIHSS)score in both groups significantly decreased,and those in the observation group were lower than the control group(P<0.05).After 7 d of treatment,the matrix metalloproteinase-2(MMP-2)and matrix metalloproteinase-9(MMP-9)levels in serum and cerebrospinal fluid significantly decreased in both groups,and those in the observation group were significantly lower than the control group(P<0.05).Conclusion Head mild hypothermia combined with human immunoglobulin(pH4)for intravenous injection has a significant effect in the treatment of SVE,it can effectively protect neuronal cells in children and promote the recovery of neurological function,which is worthy of clinical promotion and application.