[关键词]
[摘要]
目的 探究甲基泼尼松龙联合人免疫球蛋白对于急性播散性脑脊髓患儿免疫功能的改善情况及临床疗效。方法 选取2017年1月-2017年12月至株洲市中心医院治疗的急性播散性脑脊髓炎患儿98例,按随机数字表法分为甲基泼尼松龙组和地塞米松组,每组均49例,两组患者均予以人免疫球蛋白400~500 mg/(kg· d),治疗3~5 d。甲基泼尼松龙组患者予以注射用甲泼尼龙琥珀酸钠10~15 mg/(kg· d),地塞米松组患者予以地塞米松0.5 mg/(kg· d)。两组均治疗1个月。另选取至株洲市中心医院体检的健康患儿49例作为对照组,采用免疫比浊法检测3组免疫球蛋白IgA、IgG、IgE、IgM,记录比较接受治疗的两组患儿症状消失时间、疗效及不良反应发生情况。结果 治疗前,与对照组比较,两组患儿IgG和IgM显著升高,差异有统计学意义(P<0.05);而两组患儿组间比较差异均无统计学意义。治疗后,两组患儿IgG和IgM水平均有下降,与治疗前相比差异均有统计学意义(P<0.05);且甲基泼尼松龙组各项指标均恢复到正常水平,与对照组比较差异均无统计学意义;而地塞米松组IgG和IgM水平高于对照组和甲基泼尼松龙组,差异有统计学意义(P<0.05)。甲基泼尼松龙组症状缓解时间短于地塞米松组,差异有统计学意义(P<0.05)。甲基泼尼松龙组治疗有效率为97.96%,高于地塞米松组的87.76%,差异有统计学意义(χ2=6.091,P<0.05)。治疗期间两组患儿均未出现严重不良反应,甲基泼尼松龙组不良反应发生率为20.41%,地塞米松组为26.83%,两组差异无统计学意义。结论 甲基泼尼松龙可明显改善急性播散性脑脊髓炎患儿的免疫功能,临床疗效好且不良反应较少,值得临床推广使用。
[Key word]
[Abstract]
Objective To investigate the effect of methylprednisolone on immune function and clinical efficacy in children with acute disseminated cerebral spinal cord.Methods 98 children with acute disseminated encephalomyelitis treated in our hospital from January 2017 to December 2017 were selected and divided into methylation prednisone group and dexamethasone group by random number table method.49 patients in each group.49 healthy children who had physical examination in our hospital were selected as the control group.Immunoglobulin assay was used to detect three groups of IgA,IgG,IgE,and IgM.The symptom remission time,efficacy,and adverse reactions of the two groups were recorded.Results There was no significant difference in IgA and IgE between the two groups of children with acute disseminated cerebral spinal cord and the control group,IgG and IgM were higher than the control group,the difference was statistically significant (P<0.05).After treatment,the levels of IgG and IgM decreased in the two groups,and the decrease in the methylprednisolone group was more obvious.The difference was statistically significant (P<0.05).The symptom remission time of methylprednisolone group was less than dexamethasone group,the difference was statistically significant (P<0.05).The effective rate of methylprednisolone group was 97.96%,higher than that of the dexamethasone group,the diffidence was statistically significant (χ2=6.091,P<0.05).No serious adverse reactions occurred during the treatment period in both groups.The prevalence of methylprednisolone was 20.41%,and that of dexamethasone was 26.83%,there was no significant difference between the two groups.Conclusion Methylprednisolone can significantly improve the immune function of children with acute disseminated encephalomyelitis,with good clinical efficacy and fewer adverse reactions.It is worthy of clinical application.
[中图分类号]
[基金项目]