神经节苷脂治疗重症手足口病患儿临床疗效及NSE和S-100β蛋白变化

目的探讨神经节苷脂对重症手足口病(HFMD)患儿疗效,以及血清神经元特异性烯醇化酶(NSE)和血浆S-100β蛋白的影响。方法某院2011年4月—2014年6月收治的140例重症HFMD患儿随机分为常规治疗组和试验组,选择同期门诊体检健康儿童30例作为正常对照组。常规治疗组予以抗病毒、降颅压等治疗;试验组在常规治疗组基础上加用神经节苷脂,比较3组儿童NSE和S-100β蛋白水平,以及常规治疗组和试验组临床疗效。结果试验组总有效率为91.43%(64/70),高于常规治疗组78.57%(55/70)(χ2=4.54,P0.05)。重症HFMD患儿NSE及S-100β蛋白分别为(17.63±4.21)μg/L、(492.05±119.33)ng/L,均高于对照组[分别为(8.79±2.12)μg/L、(296.35±91.02)ng/L](均P0.01)。治疗前,常规治疗组和试验组患儿血清NSE、S-100β蛋白水平比较,差异均无统计学意义(均P0.05);治疗10 d后,两组患儿血清NSE、S-100β蛋白水平均低于治疗前(均P0.01),且试验组NSE、S-100β蛋白下降水平分别为(10.18±2.36)μg/L、(247.55±64.64)ng/L,均高于常规治疗组[分别为(5.87±3.03)μg/L、(113.97±43.44)ng/L](均P0.01)。结论神经节苷脂对重症HFMD患儿有明显的疗效,可有效降低脑组织损伤标志物NSE及S-100β蛋白。

Clinical efficacy of ganglioside on treatment of severe hand foot mouth disease and changes in neuron specific enolase and S 100 β protein

ObjectiveTo evaluate  the efficacy of ganglioside on treatment of severe hand foot mouth disease (HFMD) in children, and effect on serum neuron specific enolase (NSE) as well as plasma S 100 β protein levels.MethodsOne hundred and forty cases of severe HFMD patients in a hospital from April 2011 to June 2014 were  randomly divided into routine therapy group and trial group, and 30 healthy children who received physical examination in outpatient department during the same period were selected as control.  Children in routine therapy group were given antiviral and intracranial decompression therapy; trial group were administered ganglioside in addition to routine therapy , levels of NSE and S 100 β protein levels of 3 groups, as well as clinical efficacy between  routine therapy group and trial group were compared. ResultsTotal efficacy rate of trial group was significantly higher than routine therapy group ( 91.43%［64/70］ vs  78.57%［55/70］，χ2=4.54，P＜0.05). The levels of NSE and S 100 β protein in children with severe HFMD were significantly higher than control group (［17.63±4.21）μg/L vs ［8.79±2.12］μg/L; ［492.05±119.33］ng/L vs ［296.35±91.02］ng/L，both P＜0.01) . NSE and S 100 β protein levels of routine therapy group and trial group before treatment were not significantly different(both P>0.05); after 10 day treatment, NSE and S 100 β protein levels of both groups were lower than before treatment (both P＜0.01),  the decreasing level of NSE and S 100 β protein in trial group were both higher than routine therapy group（［10.18±2.36］ μg/L vs ［5.87±3.03］μg/L; ［247.55±64.64］ng/L vs ［113.97±43.44］ng/L ) (both P＜0.01). ConclusionGanglioside has obvious therapeutic efficacy on severe HFMD in children, and can effectively reduce brain damage markers NSE and S 100 β protein.