甲基强的松龙联合免疫球蛋白治疗重症病毒性脑炎疗效观察

目的：观察甲基强的松龙联合免疫球蛋白治疗重症病毒性脑炎的临床疗效。方法将47例重症病毒性脑炎患儿按随机数字表法分为治疗组26例和对照组21例，两组均给予抗病毒及对症支持治疗，对照组应用地塞米松针0.5 mg/（kg·d）静脉滴注，连用3 d，之后渐减量。治疗组应用甲基强的松龙20 mg/（kg·d）静脉滴注，连用3 d，之后渐减量；免疫球蛋白1 g/（kg·d）静脉滴注，疗程1~2 d。对两组疗效及症状、体征缓解时间进行比较。结果治疗组总有效率显著高于对照组（P 〈0.05）；治疗组的症状、体征缓解时间明显短于对照组（P 〈0.01）。结论甲基强的松龙联合免疫球蛋白治疗重症病毒性脑炎可迅速缓解症状，缩短病程，疗效显著，安全可靠，值得临床推广。

Clinical observation of methylpredinsolone combined with immunoglobulin in the treatment of severe viral encephalitis

Objective To observe the curative effect of methylprednisolone combined with immunoglobulin on severe viral en-cephalitis. Methods Forty-seven children with severe viral encephalitis were divided into two groups by random number tables：26 cases in the treatment group and 21 cases in the control group. Patients in both groups were treated with anti-virus and heter-opathy. The patients in control group were given dexamethasone 0. 5 mg/（kg·d）for 3 days,then the doses were reduced gradu-ally. The patients in treatment group were given methylprednisolone 20 mg/（kg·d）for 3 days,then the were reduced gradually and immunoglobulin 1 g/（kg·d）for 1 - 2 days by intervenous drip. The clinical efficacy and remission time of symptoms and signs in the both groups were observed. Results The total effective rate of the treatment group was significantly higher than that of the control group（P 〈 0. 05 ）. The remission time of symptoms and signs of the treatment group were all significantly shorter than those of the control group（P 〈 0. 01）. Conclusion Methylpredinsolone combined with immunoglobulin for severe viral en-cephalitis can quickly relieve symptoms,and shorten the duration,which is effective and safe. It is worthy of clinical application.