大剂量丙种球蛋白对重症手足口病患儿的疗效观察  

High dose gamma-immunoglobulin for severe hand, foot and mouth disease

作　　者：潘海贤[1] 林楚容[1] 吴华红[1] 

机构地区：[1]汕头市中心医院,515041

出　　处：《国际医药卫生导报》2012年第13期1859-1861,共3页International Medicine and Health Guidance News

基　　金：汕头市科技技术项目（[2010]63号-1）

摘　　要：目的探讨大剂量丙种球蛋白治疗重症手足口病的临床疗效。方法将115例重症手足口病患儿分为小剂量组（n=57）和大剂量组（n=58）。在综合治疗的基础上，小剂量组加用丙种球蛋白0．2g/（kg·d），静脉点滴2d；大剂量组加用丙种球蛋白2g／（kg·d），静脉点滴2d。观察、对比两组患儿的主要症状、辅助检查缓解情况和临床疗效。结果小剂量组的退热时间和住院时间[（5．2±2．1）d、（13．5±4．3）d]明显比大剂量组[（3．5±1．8）d、（10．7±3．6）球P〈0．05）长。出院或转科时，小剂量组的白细胞异常和C反应蛋白的异常病例（7例和5例）明显多于大剂量组（1例和1例）（P〈0．05）。小剂量丙种球蛋白治疗重症手足口病的有效率（包括治愈和好转病例）为71．9％，明显低于大剂量组的有效率（91．4％），差异有统计学意义（P〈0．05）。结论大剂量丙种球蛋白能增强重症手足口病患者抵抗病毒的能力，缩短发热时间和住院时间，提高治疗的有效率。Objective To explore the clinical efficacy high dose gamma-immunoglobulin for severe hand, foot and mouth disease （ HFMD ）. Methods One hundred and fifteen children with severe HFMD were randomized to low- dose group （ n = 57 ） and high-dose group （ n = 58 ）. In addition to comprehensive treatment, low-dose group received intravenous gamma-immunoglobulin infusion （ 0.2 g/kgod ） for 2 days, and high-dose group received gamma-immuno- globulin （ 2 g/kg·d ） for 2 days. The relief of major symptoms and improvement of tests and the efficacy were compared between the two groups. Results The duration of fever and length of hospital stay were significantly longer in the low-dose group than in high-dose group [（ 5.2 ± 2.1 ） d vs. （ 3.5 ± 1.8 ） d and （ 13.5 ± 4.3 ） d vs. （ 10.7 ± 3.6 ）d, P〈 0.05 ）]. At the time of discharge or transfer, the eases of abnormal leucocytes and C-reaction protein were significantly more in low- dose group than in high-dose group （ 7 vs. 1 cases and 5 vs. 1 eases, P〈 0.05 ）. The effectiveness rate （ including cured and improved eases ） in low-dose group was significantly lower than that in the high-dose group （ 71.9% vs. 91.4%, P〈 0.05 ）. Conelusions Applieation of high dose gamma-immunoglobulin ean improve the antiviral effeet in ehildren with HFMD, shorten duration of fever and length of hospital stay, and increase the therapeutic effeet.

关 键 词：重症手足口病 丙种球蛋白 大剂量 

分 类 号：R725.1[医药卫生—儿科]