丙种球蛋白联合糖皮质激素治疗自身免疫性脑炎的效果分析

Effect of Gamma Globulin Combined with Glucocorticoids in the Treatment of Autoimmune Encephalitis

目的:探究丙种球蛋白联合糖皮质激素治疗自身免疫性脑炎的效果。方法:选取2019年6月—2021年6月扬州大学附属医院收治的106例自身免疫性脑炎患者为研究对象,根据随机数表法将其分为联合组、常规组,各53例。常规组接受糖皮质激素治疗,联合组采用丙种球蛋白联合糖皮质激素治疗。治疗4周后,比较两组的疗效、治疗期间不良反应发生率,以及治疗前后血清指标[神经元特异性烯醇化酶(NSE)、静脉血肿瘤坏死因子-α(TNF-α)水平]、脑脊液中肺表面活性物质相关蛋白D(SP-D)水平、脑脊液压力。结果:联合组治疗总有效率为94.34%,高于常规组的79.25%,差异有统计学意义(P<0.05)。治疗前,两组TNF-α、NSE水平比较,差异无统计学意义(P>0.05);治疗后,两组NSE及TNF-α水平均低于治疗前,且联合组TNF-α、NSE水平低于常规组,差异有统计学意义(P<0.05)。治疗前,两组脑脊液SP-D、脑脊液压力比较,差异无统计学意义(P>0.05);治疗后,两组脑脊液SP-D水平高于治疗前,脑脊液压力低于治疗前,且联合组脑脊液SP-D水平高于常规组,脑脊液压力低于常规组,差异有统计学意义(P<0.05)。联合组不良反应发生率为3.77%,低于常规组的15.09%,差异有统计学意义(P<0.05)。结论:丙种球蛋白联合糖皮质激素治疗自身免疫性脑炎的效果显著,有利于改善自身免疫性脑炎患者血清指标,平衡机体免疫反应,有效降低不良反应发生率。

Objective:To explore the effect of of Gamma Globulin combined with glucocorticoids in the treatment of autoimmune encephalitis.Method:A total of 106 patients with autoimmune encephalitis admitted to Affiliated Hospital of Yangzhou University from June 2019 to June 2021 were selected as the study objects and they were divided into combined group and conventional group based on the random number table method,with 53 patients in each group.The conventional group received glucocorticoid treatment,and the combined group received Gamma Globulin combined with glucocorticoids treatment.After 4 weeks of treatment,the efficacy,incidence of adverse reactions during treatment,and serum indicators[neuron specific enolase(NSE)and tumor necrosis factor-α(TNF-α)in venous blood]the level of pulmonary surfactant associated protein D(SP-D)in cerebrospinal fluid,and cerebrospinal fluid pressure before and after treatment of the two groups were compared.Result:The total effective rate of the combined group was 94.34%,which was higher than 79.25%of the conventional group,the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in NSE,TNF-αlevels between the two groups(P>0.05).After treatment,the levels of NSE,TNF-αin both groups were lower than those before treatment,while the levels of NSE,TNF-αin the combined group were lower than those in the conventional group,the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in cerebrospinal fluid SP-D and cerebrospinal fluid pressure between the two groups(P>0.05).After treatment,the cerebrospinal fluid SP-D levels in the two groups were higher than that before treatment,and the cerebrospinal fluid pressure was lower than that before treatment,moreover,the cerebrospinal fluid SP-D level in the combined group was higher than that in the conventional group,and the cerebrospinal fluid pressure was lower than that in the conventional group,the differences were statistically significant(P<0.05).The adverse reaction rate of the combined group was 3.77%,which was lower than 15.09%of the conventional group,the difference was statistically significant(P<0.05).Conclusion:The effect of Gamma Globulin combined with glucocorticoids in the treatment of autoimmune encephalitis is significant,which is conducive to improving the serum indexes of patients with autoimmune encephalitis,balancing the immune response,and effectively reducing the rate of adverse reactions.