免疫球蛋白对小儿轮状病毒性肠炎的疗效研究

目的：探讨免疫球蛋白对小儿轮状病毒性肠炎的疗效及肠道免疫机制。方法选取2014年9月至2015年12月期间在浙江省临海市第二人民医院儿科治疗的急性小儿轮状病毒性肠炎引起的腹泻患儿64例，将其按照随机数字表法分为两组，每组32例。对照组采用常规对症治疗并给予安慰剂；研究组在常规对症治疗的基础上，给予静脉滴注免疫球蛋白。对比两组患者临床症状改善情况及主要炎性因子水平变化，收集治疗后的新鲜大便标本检测两组患儿的分泌型免疫球蛋白A（ SIgA）的水平变化，并加以分析。结果治疗后研究组总有效率（84．37％）高于对照组总有效率（56．25％），差异有统计学意义（χ2＝6．063， P＜0．05）；治疗后两组血清肿瘤坏死因子－α（TNF-α）和白细胞介素－6（IL-6）水平均较治疗前降低，治疗后研究组TNF-α、IL-6水平显著低于对照组，差异均有统计学意义（t值分别为3．888和4．451，均P＜0．05）；两组治疗后SIgA水平较治疗前均有所提升，其中研究组治疗1～5天内的SIgA水平均显著高于同期对照组水平，差异均有统计学意义（t值分别为6．572、15．358、18．663、12．461、17．143，均P＜0．05）。结论免疫球蛋白能显著提高小儿轮状病毒性肠炎的治愈率，减轻患儿炎性反应，提高机体自身免疫力，促进临床症状改善。

Effectiveness of immunoglobulin on pediatric rotavirus enteritis

Objective To investigate the therapeutic effect of immunoglobulin on pediatric rotavirus enteritis and intestinal immune mechanism.Methods Totally 64 cases of acute infantile diarrhea caused by rotavirus enteritis admitted in the Second People ’s Hospital of Linhai City during September 2014 to December 2015 were selected.And they were randomly divided into two groups according to random number table with 32 cases in each group.Control group received routine treatment and placebo .Besides the routine treatment , immunoglobulin group was given intravenous immunoglobulin .The improvement of clinical symptoms and the changes of main inflammatory factors were compared between two groups .The changes of their secretory immunoglobulin A (SIgA) levels were detected and analyzed by collecting fresh feces from children in two groups who received treatment .Results After treatment, the total effective rate of the immunoglobulin group (84.37%) was higher than that of the control group (56.25%).The difference was statistically significant (χ2 =6.063, P<0.05).The serum tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) levels in two groups were lower than those before treatment .And the levels of TNF-αand IL-6 in the immunoglobulin group were significantly lower than those in the control group . The differences were statistically significant (t value was 3.888 and 4.451, respectively, both P<0.05).The level of SIgA increased in two groups after treatment .In the first five days of treatment , the SIgA levels in the immunoglobulin group were significantly higher than those in the control group with statistically significant (t value was 6.572, 15.358, 18.663, 12.461 and 17.143, respectively, all P<0.05).Conclusion Immunoglobulin can significantly improve the cure rate of pediatric rotavirus enteritis and relieve inflammatory reaction to enhance the immunity and promote the improvement of clinical symptoms .