免疫球蛋白联合注射用甲泼尼龙琥珀酸钠冲击治疗在自身免疫性脑炎中的应用效果

Effect of immunoglobulin combined with methylprednisolone sodium succinate for injection implosive therapy on 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在自身免疫性脑炎中的应用价值。方法:抽取2016年4月至2022年4月驻马店市中心医院收治的自身免疫性脑炎患者60例,按随机数字表法分为对照组与观察组,每组30例。对照组采用注射用甲泼尼龙琥珀酸钠冲击治疗,观察组在对照组基础上采用免疫球蛋白联合治疗。对比两组临床疗效、精神好转时间、症状消失时间、住院时间及不良反应发生率。比较两组治疗前后T淋巴细胞亚群(CD3^(+)、CD4^(+))及炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平。结果:观察组总有效率(96.67%,29/30)高于对照组(70.00%,21/30),P<0.05。治疗后,观察组精神好转、症状消失及住院时间短于对照组(P<0.05)。治疗后,观察组CD3^(+)、CD4^(+)水平高于对照组(P<0.05);治疗后,观察组IL-6、TNF-α水平低于对照组(P<0.05)。观察组不良反应发生率(13.33%,4/30)与对照组(20.00%,6/30)比较差异未见统计学意义(P>0.05)。结论:自身免疫性脑炎应用免疫球蛋白联合注射用甲泼尼龙琥珀酸钠冲击治疗,可增强免疫功能、减轻炎症反应,改善临床症状,提高治疗效果。

Objective To investigate the application value of immunoglobulin combined with methylprednisolone sodium succinate for injection implosive therapy in the treatment of autoimmune encephalitis.Methods Sixty patients with autoimmune encephalitis treated in Zhumadian Central Hospital from April 2016 to April 2022 were selected and divided into control group and observation group according to random number table method,with 30 cases in each group.The control group received implosive therapy with methylprednisolone sodium succinate for injection,and the observation group received immunoglobulin based on the treatment of the control group.The clinical efficacy,mental improvement time symptom disappearance time,hospital stay time and the incidence of adverse reactions were compared between the two groups.The levels of T lymphocyte subsets,including cluster of differentiation 3^(+)(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+)),inflammatory factors,including tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),were compared between the two groups before and after treatment.Results The total effective rate of the observation group(96.67%,29/30)was higher than that of the control group(70.00%,21/30),P<0.05.After treatment,the mental improvement time,symptom disappearance time and hospitalization time of the observation group were shorter than those of the control group(P<0.05).After treatment,the levels of CD3^(+) and CD4^(+) in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of IL-6 and TNF-αin the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(13.33%,4/30)and the control group(20.00%,6/30),P>0.05.Conclusions Immunoglobulin combined with methylprednisolone sodium succinate for injection implosive therapy,in the treatment of autoimmune encephalitis,can enhance immune function,reduce inflammatory response,improve clinical symptoms and improve therapeutic effect.