摘要
目的:探讨短程甲基强的松龙冲击联合高压氧对重症病毒性脑炎(VE)患儿血清S100B蛋白、神经生长因子(NGF)水平及预后的影响。方法:选取2015年6月~2017年6月我院重症VE患儿116例,以随机数字表法分为对照组(n=58)与观察组(n=58)。两组均给予常规治疗,于此基础上对照组采取短程甲基强的松龙冲击治疗,观察组采取短程甲基强的松龙冲击联合高压氧治疗。对比两组治疗效果、临床症状消失时间、治疗后6个月后遗症发生率及治疗前后血清氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、S100B蛋白、NGF水平。结果:治疗后观察组总有效率96.55%(56/58)高于对照组82.76%(48/58)(P<0.05);观察组发热、呕吐、头痛、脑膜刺激征、意识障碍等临床症状消失时间短于对照组(P<0.05);两组治疗前血清MDA、SOD水平对比,差异无显著统计学意义(P>0.05),两组治疗后血清MDA水平较治疗前降低,血清SOD水平较治疗前升高,且观察组血清MDA水平低于对照组,血清SOD水平高于对照组(P<0.05);两组治疗后血清S100B蛋白、NGF水平均较治疗前降低,且观察组低于对照组(P<0.05);观察组治疗后6个月症状性癫痫、智力障碍、肢体运动障碍等后遗症发生率3.45%(2/58)低于对照组15.52%(9/58)(P<0.05)。结论:应用短程甲基强的松龙冲击联合高压氧治疗重症病毒性脑炎患儿可显著提升治疗效果,减轻患儿临床症状,降低患儿血清S100B蛋白、NGF水平,缓解机体氧化应激反应及神经功能损伤,减少后遗症的发生。
Objective:To explore the effect of short-term methylprednisolone combined with hyperbaric oxygen on serum S100 B protein,nerve growth factor(NGF) level and prognosis in children with severe viral encephalitis(VE).Methods: 116 cases of severe VE in our hospital from June 2015 to June 2017 were randomly divided into control group(n=58) and observation group(n=58).The two groups were treated with routine treatment.On this basis,the control group took short-term methylprednisolone impact therapy,and the observation group took short-term methylprednisolone impact combined hyperbaric oxygen therapy.The treatment effect and disappearance time of clinical symptoms,the incidence of sequelae after 6 months of treatment and the levels of serum oxidative stress response before and after treatment [malondialdehyde(MDA),superoxide dismutase(SOD)],S100 B protein,and NGF level of two groups were compared.Results: After treatment,the total effective rate of the observation group was 96.55%(56/58),which was higher than that of the control group(82.76%)(48/58)(P<0.05).The disappearance time of clinical symptoms of fever,vomiting,headache,meningeal irritation and disturbance of consciousness in the observation group was shorter than that in the control group(P<0.05).There was insignificant difference in serum MDA and SOD levels between the two groups before treatment(P>0.05).The level of serum MDA in the two groups was lower than that before treatment,and the level of serum SOD was higher than that before the treatment,and the level of serum MDA in the observation group was lower than that of the control group,and the level of serum SOD was higher than that of the control group(P<0.05).After treatment,the serum S100 B protein and NGF levels of the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).The incidence of sequelae such as symptomatic epilepsy,mental retardation and limb movement disorder in the observation group 3.45%(2/58) was lower than that in the control
作者
张保霞
张晓
徐瑞
ZHANG Bao-Xia;ZHANG Xiao;XU Rui(Department of Pediatrics,Nanyang First People′s Hospital,Nanyang 473000,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2019年第21期2638-2643,共6页
Chinese Journal of Immunology
