【摘要】：目的研究觀察通過靜注人免疫球蛋白(IVIG)在累及神經(jīng)系統(tǒng)的重癥手足口病患兒的臨床療效。方法對(duì)2016年3月至2016年11月在本院住院并經(jīng)IVIG治療的累及神經(jīng)系統(tǒng)手足口病重癥患兒為研究對(duì)象。對(duì)患者進(jìn)行靜注人免疫球蛋白的注射治療,并從病原菌(Ev71/Cox16/其他腸道病毒組)、炎性指標(biāo)、腦脊液檢查及免疫功能等方面進(jìn)行匯總,綜合比較IVIG療效的差異。結(jié)果 85例患兒經(jīng)IVIG治療和預(yù)后:有效,70例,7 d內(nèi)出院,治愈;效果不理想15例,有1例家長(zhǎng)放棄而死亡(住院5 d),1例經(jīng)3月康復(fù)治療仍有肢體活動(dòng)受限,余13例在出院3月內(nèi)均已恢復(fù)。x~2檢驗(yàn)顯示:(1)IVIG療效與病原菌具有相關(guān)性(x~2=7.930,P=0.005);(2)IVIG與患兒的炎性指標(biāo)高低、腦脊液異常及免疫功能低下無(wú)關(guān);(3)其他腸道病毒感染致的療效不佳率的95%CI(0%,15%);99%CI(0%,20%);Ev71/Cox16感染致的效不佳率的95%CI(14.87%,38.98%);99%CI(11.05%,42.79%)。結(jié)論 IVIG療效與致病菌有關(guān),除Ev71/Cox16外其他腸道病毒感染致神經(jīng)系統(tǒng)受累的重癥手足口病患兒IVIG療效較佳。
[Abstract]:Objective to observe the clinical effect of intravenous injection of human immunoglobulin (IVIG) in children with severe hand, foot and mouth disease (HFMD) involving the nervous system. Methods from March 2016 to November 2016, children with nervous system hand, foot and mouth disease who were hospitalized in our hospital and treated with IVIG were studied. The patients were treated with intravenous injection of human immunoglobulin and summarized from pathogenic bacteria (other enterovirus group of Ev71/Cox16/), inflammatory index, cerebrospinal fluid examination and immune function, and compared the difference of curative effect of IVIG. Results 85 cases were treated with IVIG, 70 cases were discharged within 7 days and cured. The results were not satisfactory in 15 cases. One parent gave up and died (5 d), in hospital and 1 case after 3 months rehabilitation treatment). The other 13 cases had recovered within 3 months of discharge. X2 test showed that: (1) there was a correlation between the efficacy of IVIG and the pathogenic bacteria (x2 + 7.930% P0. 005); (2) IVIG had no relation with inflammatory index, cerebrospinal fluid abnormality and immunosuppression, (3) 95%CI (0 15%) and 99%CI (0 20%) caused by other enterovirus infection. 95%CI (14.87%) and 99%CI (42.79%) caused by Ev71/Cox16 infection. Conclusion the curative effect of IVIG is related to pathogenic bacteria. The effect of IVIG in children with severe hand, foot and mouth disease caused by enterovirus infection other than Ev71/Cox16 is better.
【作者單位】： 吉林大學(xué)第一醫(yī)院藥學(xué)部;
【分類號(hào)】：R725.1

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