大剂量丙种球蛋白静脉注射治疗小儿重症病毒性脑炎疗效观察

目的观察大剂量丙种球蛋白静脉注射治疗小儿重症病毒性脑炎的临床效果。方法抽取2017年6月-2018年7月邵阳市中心医院收治的小儿重症病毒性脑炎患儿136例,根据丙种球蛋白的治疗剂量分为2组,试验组68例行大剂量丙种球蛋白治疗,对照组68例行小剂量丙种球蛋白治疗。比较2组临床疗效、治疗前后神经功能指标、炎性因子水平及不良反应发生情况。结果试验组总有效率为97.06%,高于对照组的86.76%(χ2=4.847,P<0.05)。治疗后,2组NSE、NGF、MBP、S-100β、CK-BB、IL-1、IL-6、CRP、INF-γ水平均下降(P<0.05),且试验组低于对照组(P<0.01)。2组不良反应发生率比较差异无统计学意义(χ2=0.208,P>0.05)。结论在常规治疗基础上,大剂量丙种球蛋白静脉注射治疗小儿重症病毒性脑炎可减轻患儿炎性反应及神经损害,改善患儿临床症状及体征,且大剂量用药不会增加不良反应发生率,值得临床广泛推广。

Observation on the effect of intravenous injection of high-dose gamma globulin in children with severe viral encephalitis

Objective To observe the clinical effect of intravenous injection of high-dose gamma globulin in children with severe viral encephalitis.Methods 136 children with severe viral encephalitis treated in the Central Hospital of Shaoyang from June 2017 to July 2018 were selected,and they were divided into 2 groups according to the therapeutic dose of gamma globulin,the experimental group(68 cases)received high-dose gamma globulin therapy,the control group(68 cases)was treated with low-dose gamma globulin.The clinical efficacy,nerve function,inflammatory factor levels,and adverse reactions were compared between the two groups.Results The total effective rate in the experimental group(97.06%)was higher than the control group(86.76%)(χ2=4.847,P<0.05).After treatment,the levels of NSE,NGF,MBP,S-100β,CK-BB,IL-1,IL-6,CRP,and INF-γdecreased in the two groups(P<0.05),and the experimental group was lower than those of the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.208,P>0.05).Conclusion On the basis of conventional treatment,intravenous injection of high-dose gamma globulin in children with severe viral encephalitis can reduce inflammatory reactions and nerve damage,improve clinical symptoms and signs in children,high-dose medication will not increase the incidence of adverse reactions,it deserves widespread clinical promotion.