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目的观察大剂量丙种球蛋白联合干扰素治疗重症小儿手足口病合并病毒性脑炎的免疫学效果。方法将184例重症手足口病合并病毒性脑炎患儿随机分为试验组和对照组各92例。试验组在常规治疗的基础上给予大剂量丙种球蛋白联合干扰素治疗,对照组在常规治疗的基础上给予干扰素治疗。对比观察2组患儿治疗前后免疫学效果差异。结果治疗前2组患者CD+3T、CD+4T、CD+8T细胞百分比及CD+4/CD+8值均相近,差异无统计学意义(P>0.05)。治疗后2组患者CD+3T、CD+4T细胞百分比及CD+4/CD+8值均上升,CD+8T细胞百分比下降,且试验组波动幅度大于对照组,差异有统计学意义(P<0.05)。治疗前2组患者血清中IL-6、TNF-α及IGF-1水平均相近,差异无统计学意义(P>0.05)。治疗后2组患者血清中IL-6和TNF-α水平均下降,IGF-1水平均上升,且试验组波动幅度大于对照组,差异均有统计学意义(P<0.05)。结论大剂量丙种球蛋白联合干扰素可显著改善重症小儿手足口病合并病毒性脑炎患者的免疫学水平,抑制炎性反应。
Objective To observe the immunological effects of high-dose gamma globulin combined with interferon in the treatment of HFMD complicated with viral encephalitis in critically ill children. Methods 184 cases of severe HFMD with viral encephalitis were randomly divided into experimental group and control group, 92 cases each. The experimental group was given high-dose gamma globulin combined with interferon on the basis of routine treatment, and the control group was treated with interferon on the basis of routine treatment. Comparison of two groups of children before and after treatment immunological differences. Results The percentage of CD + 3T, CD + 4T, CD + 8 T cells and CD + 4 / CD + 8 in the two groups before treatment were similar, with no significant difference (P> 0.05). After treatment, the percentage of CD + 3T, CD + 4T cells and CD + 4 / CD + 8 increased and the percentage of CD + 8T cells decreased in both groups. The fluctuation range of experimental group was more than that of control group (P < 0.05). The serum levels of IL-6, TNF-αand IGF-1 in the two groups before treatment were similar, with no significant difference (P> 0.05). After treatment, the serum levels of IL-6 and TNF-α in both groups decreased and the levels of IGF-1 increased, and the fluctuation range of the experimental group was larger than that of the control group (P <0.05). Conclusion High-dose gamma globulin combined with interferon can significantly improve the immunological level of patients with HFMD complicated with viral encephalitis in severe pediatric patients and inhibit the inflammatory reaction.