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小剂量甲基强的松龙联合丙种免疫球蛋白治疗重症手足口病患儿的疗效及安全性分析 被引量:1

Efficacy and Safety Analysis of Low-dose Methylprednisolone Combined with Immunoglobulin C in the Treatmentof Children with Severe Hand, foot and Mouth Disease
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摘要 目的:结合临床实践经验,探讨小剂量甲基强的松龙联合丙种免疫球蛋白治疗重症手足口病患儿的疗效及安全性,为今后治疗小儿手足口病提供参考依据。方法:选取南阳市中心医院2016年1月—2020年1月收治的90例重症手足口病患儿作为研究对象,经随机数表法将研究者随机分为对照组(45例)和观察组(45例)。对照组给予静脉滴注小剂量甲基强的松龙治疗,观察组在此基础上给予肌肉注射丙种免疫球蛋白治疗。比较两组患儿治疗前后观察患儿免疫功能,包括:T淋巴细胞亚群CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)及自然杀伤细胞(NK)的变化情况,观察患儿的近期临床疗效,观察治疗期间患儿的不良反应发生情况来评价安全性。结果:治疗前两组患儿CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)及NK比较,差异无统计学意义(t=5.474、6.245、9.912、6.358,P>0.05),与治疗前比较,治疗后两组患者CD4^(+)、CD4^(+)/CD8^(+)及NK均升高,CD8^(+)降低,差异有统计学意义(t=7.489、9.752、9.847、6.531,P<0.05),且观察组CD4^(+)、CD4^(+)/CD8^(+)及NK高于对照组,CD8^(+)低于对照组。治疗后两组临床疗效比较,观察组有效率更高,差异有统计学意义(χ^(2)=3.92,P<0.05),有效率可达到91.11%。治疗期间两组均无严重不良反应,总不良反应发生率比较,差异无统计学意义(χ^(2)=1.813,P>0.05)。结论:以小剂量甲基强的松龙联合丙种免疫球蛋白治疗重症手足口病患儿,可提高患儿的免疫功能,疗效显著,且不增加不良反应,安全性较高,值得临床进一步推广应用。 Objective:To explore the efficacy and safety of low-dose methylprednisolone combined with immunoglobulin C in the treatment of severe hand-foot-mouth disease(HFMD)in children,and to provide reference for future treatment of HFMD in children.Methods:A total of 90 children with severe hand,foot and mouth disease admitted to the hospital from January 2016 to January 2020 were included and divided into control group and observation group according to the random number table method,with 45 cases in each group.The control group was given intravenous infusion of low-dose methylprednisolone,and the observation group was given intramuscular injection of immunoglobulin C on this basis.The immune function of the children before and after treatment,including the changes of T lymphocyte subsets CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and natural killer cells(NK)were compared.The short-term clinical efficacy of the children and the occurrence of adverse reactions of the children during the treatment were ob⁃served to evaluate the safety.Results:There was no significant difference in CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and NK between the two groups before treatment(t=5.474,6.245,9.912,6.358,P>0.05).Compared with before treatment,after treatment,CD4^(+),CD4^(+)/CD8^(+)and NK in the two groups all increased,and CD8^(+)decreased,and the difference was statistically significant(t=7.489,9.752,9.874,6.531,P<0.05).CD4^(+),CD4^(+)/CD8^(+)and NK in the observation group were higher than those in the control group,while CD8^(+)was lower than that in the control group.After treatment,the clinical efficacy of the observation group was higher,and the difference was statistically significant(χ^(2)=3.92,P<0.05),and the effective rate reached 91.11%.During the treatment period,there were no se⁃rious adverse reactions in the two groups,and there was no significant difference in the incidence of total adverse reactions(χ^(2)=1.813,P>0.05).Conclusion:Low-dose methylprednisolone combined with immunoglobulin C in the treatment of severe hand-foot-mouth dis
作者 赵静 张义堂 李爽 杨红 ZHAO Jing;ZHANG Yi-tang;LI Shuang(PICU,Nanyang Central Hospital,Nanyang,Henan,473009,China)
出处 《黑龙江医学》 2022年第13期1572-1574,共3页 Heilongjiang Medical Journal
关键词 重症手足口病 甲基强的松龙 丙种免疫球蛋白 Severe hand,foot and mouth disease Methylprednisolone Immunoglobulin C
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