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  本文選題：吉蘭-巴雷綜合征 + 丙種球蛋白�。� 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的探討鼠神經(jīng)生長因子(mNGF)聯(lián)合丙種球蛋白(IVIG)治療小兒脫髓鞘型吉蘭-巴雷綜合征(GBS)的療效。 方法對自1995年1月至2011年12月期間我院收治的共51例脫髓鞘型GBS患兒的臨床資料進行回顧性比較分析,臨床表現(xiàn)、體征及輔助檢查結(jié)果等均符合國際GBS的診斷標準。根據(jù)既往的治療方案共分為兩組,mNGF+IVIG組32例：男20例,女12例；IVIG組19例：男11例,女8例。IVIG組給予IVIG0.4g/(kg·d)靜脈滴注,連用5d,并輔以維生素B6、B1和胞二磷膽堿等營養(yǎng)神經(jīng)治療以及針灸、按摩等康復(fù)治療,防止感染及其他對癥支持治療；mNGF+IVIG組在IVIG組治療的基礎(chǔ)上,加用mNGF20ug im qd治療,連用4周。兩組定期行Hughes肢體運動功能評分及神經(jīng)電生理檢查(包括運動神經(jīng)傳導(dǎo)速度及F波潛伏期),觀察記錄療效及藥物不良反應(yīng)情況,將結(jié)果進行統(tǒng)計學(xué)分析。 結(jié)果兩組病例在一般臨床資料,如年齡、性別、前驅(qū)感染等方面進行比較(P0.05),具有可比性。全部患兒治療4周后行肢體運動功能評分,mNGF+IVIG組恢復(fù)明顯好于IVIG組(P0.05)；mNGF+IVIG組恢復(fù)至能獨立行走5m所用的時間較單純IVIG組明顯縮短(P0.05)；治療后3個月,神經(jīng)電生理檢測顯示mNGF+IVIG組運動神經(jīng)傳導(dǎo)速度及F波平均潛伏期恢復(fù)均較IVIG組快(P0.05)。兩組病例在治療過程中均未見嚴重的不良反應(yīng)發(fā)生。 結(jié)論mNGF聯(lián)合IVIG治療小兒脫髓鞘型吉蘭-巴雷綜合征的療效較單純應(yīng)用丙種球蛋白治療效果更顯著,運動功能恢復(fù)增快,明顯縮短病程,改善神經(jīng)電生理指標,并且無嚴重不良反應(yīng),值得臨床廣泛推廣應(yīng)用。
[Abstract]:Objective to investigate the effect of nerve growth factor NGF (NGF) combined with immunoglobulin (IVIGG) on demyelinating Guillain-Barre syndrome (GBS) in children. Methods the clinical data of 51 cases of demyelinating type GBS from January 1995 to December 2011 were analyzed retrospectively. The clinical manifestations, signs and auxiliary examination results were in accordance with the diagnostic criteria of international GBS. According to the previous treatment regimen, 32 patients in the IVIG group were divided into two groups: male 20, female 12: M 11, F 8. IVIG group were given IVIG0.4g/(kg d intravenous drip for 5 days, supplemented with nutritional nerve therapy such as vitamin B6 and citicoline, as well as acupuncture and moxibustion. IVIG group was treated with mNGF20ug im QD for 4 weeks on the basis of IVIG treatment. Hughes motor function score and electrophysiologic examination (including motor nerve conduction velocity and F-wave latency) were performed regularly in both groups. The curative effects and adverse drug reactions were recorded and the results were analyzed statistically. Results the two groups were compared in general clinical data, such as age, sex, preinfection and so on. After 4 weeks of treatment, the recovery time to 5 m in the IVIG group was significantly better than that in the IVIG group, and the recovery time to 5 m in the IVIG group was significantly shorter than that in the IVIG group, 3 months after the treatment, the recovery time was significantly shorter than that in the simple IVIG group, 3 months after the treatment, the recovery time was significantly shorter than that in the IVIG group, and the recovery time was significantly shorter than that in the IVIG group. Nerve electrophysiological examination showed that motor nerve conduction velocity and average latency of F wave recovered faster in mNGF IVIG group than in IVIG group (P 0.05). There were no serious adverse reactions in both groups. Conclusion the curative effect of mNGF combined with IVIG in the treatment of children's demyelinating type Guillain-Barre syndrome is more obvious than that of the simple application of gamma globulin, the recovery of motor function is faster, the course of disease is shortened obviously, and the electrophysiological indexes of nerve are improved. And no serious adverse reactions, worthy of clinical wide application.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R745.43

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相關(guān)期刊論文 前2條

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本文編號：1971259