不同剂量重组人干扰素对重症手足口病患儿中枢神经系统的影响

Effects of different doses of recombinant human interferon on central nervous system of severe hand, foot and mouth disease

  • 摘要:
      目的  探讨重组人干扰素α-1b不同应用剂量对重症手足口病患儿中枢神经系统的影响。
      方法  选取接受治疗的264例重症手足口病患儿为研究对象, 按照随机数表法平均分为3组,对照组患儿采用利巴韦林治疗,低剂量组患儿在利巴韦林治疗基础上加以2 μg/kg的重组人干扰素α-1b进行治疗,高剂量组患儿在利巴韦林治疗基础上加以4 μg/kg的重组人干扰素α-1b进行治疗。观察并比较3组患儿的血清学指标、血常规结果及临床症状改善情况。
      结果  3组患儿的C反应蛋白水平无显著差异(P>0.05)。对照组患儿的神经特异性烯醇化酶和S-100蛋白水平显著高于低剂量组和高剂量组(P < 0.05), 低剂量组患儿的神经特异性烯醇化酶和S-100蛋白水平显著高于高剂量组(P < 0.05)。3组患儿的血小板计数无显著差异(P>0.05)。对照组患儿的中性粒细胞计数显著高于低剂量组和高剂量组(P < 0.05)。对照组患儿的皮疹消退时间、发热消退时间显著长于低剂量组和高剂量组(P < 0.05); 低剂量组患儿的皮疹消退时间、发热消退时间显著长于高剂量组(P < 0.05)。
      结论  重组人干扰素α-1b在重症手足口病的治疗中具有显著效果,能够显著改善患儿的临床症状,雾化吸入高剂量重组人干扰素α-1b对于中枢神经系统的保护作用更加显著,临床应用时应结合患儿的耐受能力选择用药剂量。

     

    Abstract:
      Objective  To explore the effects of different doses of recombinant human interferon alpha α-1b on central nervous system of severe hand, foot and mouth disease.
      Methods  A total of 264 children with severe hand, foot and mouth disease treated in our hospital were selected as research objects. According to the random number table method, the children were divided into three groups, the control group was treated with ribavirin, the low dose group was treated with 2 μg/kg recombinant human interferon α-1b on the basis of ribavirin, and high dose group was treated with 4 μg/kg recombinant human interferon α-1b. Serological parameters, blood routine results and improvement of clinical symptoms were observed and compared.
      Results  There was no significant difference in C Reactive Protein (CRP) among the three groups (P>0.05). The levels of nervous specific enolase and S-100 protein in the control group were significantly higher than those in the low-dose group and the high-dose group (P < 0.05), and were significantly higher in the low-dose group than those in the high-dose group (P < 0.05). There was no significant difference in platelet count among the three groups (P>0.05). The neutrophils count in the control group was significantly higher than that in the low-dose group and the high-dose group (P < 0.05). The subsidence time of fever and skin rash of the control group were significantly longer than those of the low-dose group and the high-dose group (P < 0.05), and were significantly higher in the low-dose group than those of the high-dose group (P < 0.05).
      Conclusion  Recombinant human interferon α-1b has significant effect in the treatment of severe hand, foot and mouth disease. It can significantly improve the clinical symptoms of children, and has a significant protective effect on the central nervous system for atomization inhalation of high-dose recombinant human interferon α-1b. Therefore, the dosage should be selected according to the tolerance of children.

     

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