高压氧联合氢化可的松对病毒性脑炎患儿的疗效

Efficacy of hyperbaric oxygen combined with hydrocortisone on children with viral encephalitis

目的探讨高压氧联合氢化可的松治疗病毒性脑炎(viral encephalitis,VE)患儿的效果及对患儿肢体运动功能、血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、髓鞘碱性蛋白(myelin basic protein,MBP)、β-内啡肽(β-endorphin,β-EP)水平及脑电图变化的影响。方法将176例VE患儿随机均分为2组,每组88例。对照组在常规治疗基础上给予氢化可的松注射液,观察组在对照组治疗的基础上给予高压氧辅助治疗。检测患儿的血清神经相关蛋白表达水平、血清炎症因子水平,用运动功能量表(Fugl-Meyer,FMA)评价2组患儿的肢体运动功能,记录临床症状消失时间和治疗有效率,监测2组患儿的脑电图变化。记录不良反应发生情况。结果治疗后,2组患儿的NSE、MBP、β-EP、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)在血清中的表达水平均较治疗前显著降低(P<0.05),2组患儿运动功能评分均较治疗前明显提高(P<0.05);观察组较对照组患儿的临床症状消失时间明显缩短(P<0.05);观察组与对照组脑电图异常率(19.32%vs.40.91%)和治疗总有效率(96.59%vs.86.36%)比较差异有统计学意义(P<0.05),不良反应发生率(13.64%vs.14.77%)比较差异无统计学意义。结论高压氧联合氢化可的松治疗VE患儿疗效较好,能加快患儿临床症状的恢复,降低NSE、MBP和β-EP水平,提高肢体运动功能,具有较好的安全性。

Objective To explore the effect of hyperbaric oxygen combined with hydrocortisone in children with viral encephalitis(VE),and the effects on the motor function of children’s limbs,the serum levels of neuron specific enolase(NSE),myelin basic protein(MBP)andβ-endorphin(β-EP),and the electroencephalogram(EEG)changes.Methods 176 children with VE were randomly divided into 2 groups,with 88 cases in each group.The control group was given Hydrocortisone Injections on the basis of basic treatment,and the observation group was combined with hyperbaric oxygen adjuvant therapy on the basis of the control group.The expression levels of serum nerve-related protein and the levels of serum inflammatory factors were detected,and the motor function of the 2 groups of children were evaluated by the motor function scale(Fugl-Meyer,FMA).The time of clinical symptoms disappeared,the effective rate,the changes of EEG,and the occurrence of adverse reactions were recorded.Results After treatment,the expression levels of NSE,MBP,β-EP,interleukin-1β(IL-1β)、interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the serum of the 2 groups were significantly lower than before treatment(P<0.05).After treatment,the motor function of the 2 groups were significantly higher than those before treatment(P<0.05).After treatment,the disappearance of clinical symptoms of children in the observation group was significantly shorter than that in the control group(P<0.05).The abnormal rate of EEG(19.32%vs.40.91%),and the total effective rate of treatment(96.59%vs.86.36%)in the observation group and the control group was significantly different(P<0.05),but the incidence of adverse reactions(13.64%vs.14.77%)showed no significant difference(P>0.05).Conclusion Hyperbaric oxygen combined with hydrocortisone has a good effect in the treatment of children with VE,the adjuvant therapy can speed up the recovery of children s clinical symptoms,reduce the levels of NSE,MBP,andβ-EP,improve the motor function of the limbs,and have good safety.