文章摘要
重组人干扰素α-1b联合大剂量丙种球蛋白治疗重症手足口病合并病毒性脑炎的疗效
Effects of recombinant human interferon α-1b combined with high-dose gamma globulin on serum levels of T cell subsets and insulin-like growth factor -1 in children with severe hand-foot-mouth disease and viral encephalitis
投稿时间:2018-09-12  
DOI:10.3969/j.issn.1000-0399.2019.04.010
中文关键词: 病毒性脑炎  手足口病  重组人干扰素α-1b  丙种球蛋白  胰岛素样生长因子-1
英文关键词: Viral encephalitis  Hand-foot-mouth disease  Recombinant human interferon α-1b  Gamma globulin  Insulin-like growth factor-1
基金项目:四川省卫生和计划生育委员会科研(项目编号:20150172)
作者单位E-mail
闵晓兰 644000 四川省宜宾市第二人民医院儿科  
蔡强 644000 四川省宜宾市第二人民医院儿科 1492029003@qq.com 
卢玉容 644000 四川省宜宾市第二人民医院儿科  
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中文摘要:
      目的 探究重组人干扰素α-1b联合大剂量丙种球蛋白治疗重症手足口病(HFMD)合并病毒性脑炎的临床效果。方法 选取2014年2月至2017年4月宜宾市第二人民医院收治135例HFMD并病毒性脑炎患儿,按随机数字表法分为对照A组(重组人干扰素α-1b)、对照B组(大剂量丙种球蛋白)及观察组(重组人干扰素α-1b+大剂量丙种球蛋白),各45例。比较三组患儿疗效、治疗后血清胰岛素样生长因子-1(IGF-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、S100B、神经特异性烯醇化酶(NSE)水平及血清T细胞亚群水平变化情况。结果 观察组总有效率(93.33%)高于对照A组、B组(73.33%、73.56%),差异有统计学意义(P<0.05)。治疗后,观察组CD3+、CD4+、CD4+/CD8+、CD8+改善程度大于对照A、B组,血清IGF-1、IL-6、TNF-α、S100B、NSE改善程度大于对照A、B组,差异均有统计学意义(P<0.05)。三组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论 重组人干扰素α-1b联合大剂量丙种球蛋白治疗重症HFMD并病毒性脑炎患儿疗效显著,能显著提高患儿免疫功能,减轻机体炎性反应,缓解脑损伤,调节IGF-1水平。
英文摘要:
      Objective To investigate the clinical effect of recombinant human interferon α-1b combined with high-dose gamma globulin on children with severe hand-foot-mouth disease (HFMD) and viral encephalitis. Methods A total of 135 children with HFMD and viral encephalitis from Feb 2014 to April 2017 in Yibin Second People's Hospital were randomly divided into control group A (recombinant human interferon α-1b) and control group B (high-dose gamma globulin) and observation group (recombinant human interferon α-1b + high-dose gamma globulin) according to the random number table method, with 45 cases in each group.The therapeutic effects, serum insulin-like growth factor-1 (IGF-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), S100B, neuro-specific enolase (NSE) levels and changes in serum T cell subsets were compared among the three groups. Results The total effective rate of observation group (93.33%) was higher than that of control group A and B (73.33%, 73.56%) (P<0.05). After treatment, the improvement of CD3+, CD4+, CD4+/CD8+ and CD8+ was higher than that of control group A and B (P<0.05); the improvement of serum IGF-1, IL-6, TNF-α, S100B and NSE in observation group was higher than that in control group A and B (P<0.05); there was no significant difference in the incidence of adverse reactions among three groups (P>0.05). Conclusions The clinical effect of children with severe HFMD and viral encephalitis treated by recombinant human interferon α-1b combined with high-dose gamma globulin is significant. It can significantly improve the immune function of the children, reduce the inflammatory response, alleviate brain damage and regulate the level of IGF-1.
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