静脉注射丙种球蛋白治疗小儿重症手足口病的疗效观察和对患儿炎症因子水平的影响

王可

[摘要] 目的 觀察静脉注射丙种球蛋白治疗小儿重症手足口病的效果及对患儿炎症因子水平的影响。 方法 纳入2017年1月至2020年3月我院小儿重症手足口病患儿病例资料，共计58例，随机分为例数均为29例的观察组与对照组，分别实施常规治疗联合丙种球蛋白静脉注射治疗与常规治疗。比较两组患儿治疗前后炎症因子水平、症状消失时间及治疗效果。 结果 两组患儿白介素-6（IL-6）、C反应蛋白（CRP）以及肿瘤坏死因子-α（TNF-α）水平经过治疗均降低，与治疗前比较，差异有统计学意义（P<0.05），组间比较，观察组各项指标较对照组低，差异有统计学意义（P<0.05）;观察组与对照组在皮疹、发热、口腔溃疡症状消失时间及住院时间方面比较差异有统计学意义（P<0.05）;两组总有效率比较观察组较对照组高（93.1% vs 72.4%），差异有统计学意义（P<0.05）。 结论 静脉注射丙种球蛋白在小儿重症手足口病中的应用效果较好，对患儿炎症因子改善显著，有利于加快症状消失，效果可靠，值得临床推广。

[关键词] 丙种球蛋白;小儿重症手足口病;炎症因子;IL-6;CRP;TNF-α

[中图分类号] R725.1          [文献标识码] B          [文章编号] 1673-9701（2021）12-0076-03

Observation on the effect of intravenous injection of gamma globulin in the treatment of severe hand-foot-mouth disease in children and its influence on the level of inflammatory factors in children

WANG Ke

Department of Pediatrics， the Central Hospital of Jiamusi in Heilongjiang Province， Jiamusi   154002， China

[Abstract] Objective To observe the effect of intravenous gamma globulin in the treatment of severe hand-foot-mouth disease in children and its influence on the levels of inflammatory factors in children. Methods A total of 58 cases of severe hand-foot-mouth disease in children from January 2017 to March 2020 were enrolled and randomly divided into the observation group and the control group， with 29 cases in each group. The observation group and the control group received conventional treatment combined with intravenous gamma globulin injection and conventional treatment. The levels of inflammatory factors before and after treatment， the time of symptom disappearance， and the treatment effect were compared between the two groups. Results The levels of interleukin-6（IL-6）， C-reactive protein（CRP）， and tumor necrosis factor-α（TNF-α） in the children were reduced in the two groups after treatment， which was different from those before treatment（P<0.05）. The indicators of the observation group were lower than those of the control group， and the difference was statistically significant（P<0.05）. The observation group and the control group had statistically significant differences in the disappearance time of skin rash， fever， oral ulcers， and hospital stay（P<0.05）. The effective rate was higher in the observation group than in the control group（93.1% vs 72.4%）， which was statistically significant（P<0.05）. Conclusion The application of intravenous gamma globulin in severe hand-foot-mouth disease in children significantly improves the inflammatory factors in children， helps speed up the disappearance of symptoms， and has reliable effects， which is worthy of clinical promotion.

[Key words] Gamma globulin; Severe hand-foot-mouth disease in children; Inflammatory factor; IL-6; CRP; TNF-α

作为儿科常见的急性传染病，手足口病多由肠道病毒引起，在5岁以下儿童中有着较高的发病率，患儿表现为不同程度呼吸困难、发热、厌食，手部、足部位置出现小疱疹，严重者会累及到神经及呼吸系统[1]。若治疗不及时或治疗方式不当，将会引发脑炎、肺水肿等，威胁患儿生命安全。以往临床治疗小儿重症手足口病多以退热、抗病毒等为主，对患儿病情具有一定的改善作用，但治疗周期长，且整体疗效不佳，随着病情的进展，会加重神经及循环系统损害[2]。最新研究发现，免疫异常在小儿手足口病病理过程中有着重要的参与作用，而丙种球蛋白则被广泛应用于各类自身免疫性相关疾病及感染性疾病治疗中[3]，为研究其治疗小儿重症手足口病的有效性，收集小儿重症手足口病病例58例，分别采用不同治疗方案，对其效果予以比较，现报道如下。……