利巴韦林在单纯疱疹病毒性脑炎治疗中的应用效果观察

目的观察利巴韦林对单纯疱疹病毒性脑炎患儿的治疗效果,为该治疗方案的推广使用积累临床经验。方法选取中国人民解放军联勤保障部队第九二四医院2018年1月—2019年11月收治的80例单纯疱疹病毒性脑炎患儿为研究对象,按照随机数余数分组法均分为两组,每组各40例,分别采用更昔洛韦(10~30 mg/kg静脉滴注,3次/d,给药14 d)和利巴韦林(10~15 mg/kg静脉滴注,2次/d,给药14 d)进行治疗并对两组疗效进行对比。结果利巴韦林组总有效率(92.50%,37/40)高于更昔洛韦组(80.00%,32/40),差异有统计学意义(χ²=6.588,P=0.010);两组不良反应发生率分别为7.50%(3/40)和10.00%(4/40),差异无统计学意义。治疗后利巴韦林组和更昔洛韦组比较,C反应蛋白(15.80±5.25)mg/L vs(20.42±5.38)mg/L]、白细胞介素-6(10.24±2.75) ng/L vs(17.89±2.81)ng/L]、肿瘤坏死因子-α(35.70±9.80) ng/L vs(50.31±9.77)ng/L]、血清神经元特异性烯醇酶(9.77±1.33)μg/L vs(12.24±1.46)μg/L]和脑脊液神经元特异性烯醇酶(10.25±1.96)μg/L vs(14.11±1.89)μg/L]在利巴韦林组均低于更昔洛韦组,差异有统计学意义(P均<0.001),利巴韦林组发热消失时间(3.10±0.35)d vs(4.60±0.40)d]、头痛/呕吐消失时间(2.25±0.25)d vs(3.10±0.20)d]、抽搐消失时间(2.20±0.20)d vs(3.35±0.30)d]、意识障碍消失时间(4.30±0.50)d vs(6.40±0.55)d]均短于更昔洛韦组,差异有统计学意义(P均<0.001)。结论利巴韦林治疗单纯疱疹病毒性脑炎效果确切、不良反应发生率低,值得推广。

Effects of ribavirin in the treatment of herpes simplex virus encephalitis

Objective To study the effects of ribavirin in the treatment of children with herpes simplex virus encephalitis from 2018 to 2019. Methods Eighty children with herpes simplex virus encephalitis admitted to the 924 th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army from January 2018 to November 2019 were selected as the research objects, and divided into two groups according to the random number grouping method.Forty cases in each group were treated with ganciclovir(10~30 mg/kg,3 times/d,for 14 d) and ribavirin(10~15 mg/kg,2 times/d,for 14 d),respectively, and the efficacy of the two groups was compared. Results The total effective rate of ribavirin group(92.50%, 37/40) was higher than that of ganciclovir group(80.00%, 32/40), and the difference was statistically significant(χ²=6.588, P=0.010).The incidence of adverse reactions was 7.50%(3/40) and 10.00%(4/40) with no significant difference(P>0.05).After treatment, the values of C-reactive protein(15.80±5.25)mg/L vs(20.42±5.38)mg/L], interleukin-6(10.24±2.75)ng/L vs(17.89±2.81) ng/L], tumor necrosis factor-alpha(35.70±9.80) ng/L vs(50.31±9.77) ng/L], serum neuron-specific enolase(9.77±1.33)μg/L vs(12.24±1.46)μg/L], and cerebrospinal fluid neuron-specific enolase(10.25±1.96) μg/L vs(14.11±1.89)μg/L]in the ribavirin group were lower than that in the ganciclovir group;the ribavirin group′s fever disappearance time (3.10±0.35)d vs(4.60±0.40)d],headache/vomiting disappearance time (2.25±0.25)d vs(3.10±0.20)d],twitch disappearance time (2.20±0.20)d vs(3.35±0.30)d],and consciousness disturbance disappearance time (4.30±0.50)d vs(6.40±0.55)d]were shorter than that in the ganciclovir group,the difference was statistically significant(all P<0.001). Conclusions Ribavirin is effective in treating herpes simplex virus encephalitis and has a low incidence of adverse reactions.