利巴韦林、干扰素、阿昔洛韦三联疗法治疗小儿病毒性脑炎的疗效观察

目的观察利巴韦林、干扰素、阿昔洛韦联合抗病毒方法对小儿病毒性脑炎的疗效。方法 72例病毒性脑炎患儿随机分为联合组（n=28）和单一组（n=44）,联合组给予利巴韦林10～15mg/kg.d＋阿昔洛韦10mg/kg.d＋干扰素基因工程干扰素2-Ib 10～2 0万U;单一治疗组单用利巴韦林10～15mg/kg.d。治疗后观察症状和体征消失时间、实验室检查恢复情况及不良反应。结果两组患儿症状消失时间包括发热3.24±0.65vs4.32±0.87,抽搐2.36±0.38vs4.65±0.87,头痛3.18±0.68vs5.34±0.87,呕吐2.66±0.39vs4.66±0.97,意识障碍3.56±0.54vs5.82±0.91,脑膜刺激征3.91±0.48vs5.37±1.69,两组相比,联合组较单一组症状消失时间明显缩短,P〈0.05;白细胞计数恢复正常者在联合组的比率（90%）较单一组（73.3%）明显增高,P〈0.05,脑脊液常规恢复正常比率联合组（100%）较单一组（88.2%）明显增高。两组不良反应出现率无明显差异。结论利巴韦林、干扰素与阿昔洛韦三联疗法综合治疗小儿病毒性脑炎可以有效降低患儿症状和体征消退时间,并且无明显不良反应。

Combined Ribovirin, Interferon and Acyclovir for Child Viral Encephalitis

Objective To observe the curative effects of combined ribovirin,interferon and acyclovir in treating child viral encephalitis.Methods 72 children with viral encephalitis were randomly divided into 2 groups,1 combined treatment group（n=28） and 1 single treatment group（n=44）.The patients in the combined treatment group were treated with ribovirin（10～15mg/kg/d）,interferon（100,000～200,000U）and acyclovir（10mg/kg/d）and those in the single treatment group with ribovirin（10～15mg/kg/d）only.The disappearance time of symptoms and signs,recovery rate of laboratory examination and adverse reactions were observed.Results The disappearance time of symptoms and signs including fever（3.24±0.65 vs 4.32±0.87）,convulsion（2.36±0.38 vs 4.65±0.87）,headache（3.18±0.68 vs 5.34±0.87）,vomitting（2.66±0.39 vs 4.66±0.97）,disturbance of consciousness（3.56±0.54 vs 5.82±0.91 and meningeal irritation signs（3.91±0.48 vs 5.37±1.69）showed a significant difference between both the groups（P〈0.05）.The recovery rate of leukocyte count was significantly increased in the combined treatment group compared with the single treatment group（90% vs 73.3%,P〈0.05）.The cerebrospinal fluid in both groups was 100% and 88.2%,respectively.The adverse reactions showed no significant difference between both groups.Conclusions The combined treatment of child viral encephalitis with ribovirin,interferon and acyclovir can effectively reduce the disappearance time of its symptoms and signs without a conspicuous adverse reaction.