摘要
目的 观察地塞米松 (DXE)治疗对轻中度病毒性脑炎 (病脑 )患儿临床转归及T淋巴细胞亚群的影响。方法 选择66例轻中度病脑患儿 ,随机分为DXE治疗组40例和无DXM治疗组26例 ,两组均给予抗病毒和对症治疗 ,DXM治疗组加用DXM每日0.5～1.0mg/kg,疗程5～7d。治疗后3周进行临床疗效评定 ,并观察临床转归情况。采用流式细胞仪动态测定病脑患儿入院时、治疗后1周、治疗后4周外周血CD3+、CD4+、CD8+淋巴细胞变化。并与20例对照组进行比较。结果 DXE治疗组患儿治疗后发热、头痛、呕吐、颈项强直平均持续天数、临床治愈率低于无DXE治疗组(均P<0.05或<0.01) ,院内感染发生率高于无DXE治疗组(P<0.01)。治疗前两组患儿与对照组比较CD4+淋巴细胞减少 ,CD8+淋巴细胞增加 ,CD4+/CD8+下降 (均P<0.05) ,而两组患儿之间比较差别无显著性意义 (均P>0.05)。治疗后1周 ,CD4+淋巴细胞和CD4+/CD8+较治疗前均减少 ,CD8+淋巴细胞均增加 ,DXE治疗组CD4+淋巴细胞和CD4+/CD8+低于无DXE治疗组 ,CD8+淋巴细胞高于无DXM治疗组 (均P<0.05)。治疗后4周,DXE治疗组CD4+淋巴细胞、CD4+/CD8+和CD8+淋巴细胞分别较治疗后1周增高和减少 ,但仍低于和高于对照组 (均P<0.05) ;无DXE治疗组CD4+淋巴细胞、CD4+/CD8+和CD8+淋巴细胞分别较治疗前。
Objectives To observe the effect of dexamethasone(DEX)therapy on the clinical outcome and changes of lymphocyte subsets in children with mild and severe encephalitis.Methods Sixty-six children with mild and severe viral encephalitis were randomly divided into two groups:with DEX treatment(n=40)or without(n=26).The clinical efficacy was evaluated three weeks later,and the clinical manifestations were also observed.The changes of CD3 + ,CD4 + and CD8 + Tlymphocyte percentages were determined by flowcytometry on admission and at1week,4weeks after treatment.Another group of20cases was enrolled as control.Results The mean duration of fever,headache,vomiting and nuchal rigidity in DEX treatment group were much shorter than those in non-DEX treatment group.The cure rate at3weeks after DEX-treatment was lower in DEX-treatment group,accompanied by a higher incidence of hospital-acquired infections.As compared with the control,both the DEX-treatment group and the non-DEX treatment group showed a reduced CD4 + lymˉphocyte count,an increased CD8 + lymphocyte count and a lower CD4 + /CD8 + ratio(P<0.05),but there no significant differences between two patient groups(P>0.05).At1week after treatment the DEX-treatment group showed much lower CD4 + lymphocytes and CD4 + /CD8 + ratio and a higher CD8 + lymphocytes than the non-DEX-treatment group.At4weeks after treatment,the DEX-treatment group showed increased CD4 + lymphocyte count and elevated CD4 + /CD8 + ratio and a decreased CD8 + lymphocyte count when compared to those at1week after treatment,but they were still different with those of the control group.At4weeks after treatment,non-DEX treatment group showed increased CD4 + lymphocyte count and elevated CD4 + /CD8 + ratio and a decreased CD8 + lymphocyte count when compared to those before treatment and at1week after treatment, and there were no significant differences from those of the control.Conclusion DEX therapy could imˉprove the clinical signs and symptoms in children with mild and severe viral encephalitis,but at
出处
《浙江医学》
CAS
2003年第9期521-523,共3页
Zhejiang Medical Journal
