大剂量ACTH对EV71感染的手足口病危重患儿合并肾上腺功能障碍的疗效  

Curative effect of large-dose ACTH on EV71 infection combined with adrenal dysfunction in critically ill children with hand-foot-mouth disease

作　　者：谈小云[1] 

机构地区：[1]江西省儿童医院急诊科,江西南昌330006

出　　处：《中国妇幼保健》2013年第25期4149-4151,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨大剂量促肾上腺皮质激素（ adrenocorticotropic hormone, ACTH）对EV71感染的手足口病危重患儿合并肾上腺功能障碍的临床治疗效果。方法：选择2010年10月-2011年10月收治的EV71感染的合并肾上腺功能障碍的手足口病危重患儿100例作为研究对象，随机将其分为对照组和观察组，每组50例。对照组患儿采取抗病毒、降颅压、激素消炎、退热及支持疗法等常规治疗；观察组患儿在常规治疗基础上加用静脉注射大剂量ACTH（250μg／1．7m^2）进行治疗。对两组患儿疗效进行评价，并比较肾功能指标。结果：两组患儿治疗效果比较，观察组总有效率为98．0％，对照组总有效率为72．0％，两组有效率差异具有统计学意义（X^2=13．254，P=0．031）；对照组的皮质醇增值（Amax）值（3．8±2．1）μg／dl，观察组的（Amax值）为（7．1±1．8）μg/dl，差异具有统计学意义（t=10．184，P=0．008）。结论：大剂量ACTH能够显著增加EV71感染的手足口病危重患儿肾上腺功能障碍的治疗效果，改善肾上腺功能，升高血液中的皮质醇浓度，减轻肾组织损伤或功能障碍，具有重要的临床应用价值。Objective： To explore the clinical curative effect of large -dose adrenocorticotropic hormone （ACTH） on EV71 infec- tion combined with adrenal dysfunction in critically ill children with hand -foot -mouth disease. Methods： One hundred critically ill chil- dren with hand -foot -mouth disease, EV71 infection combined with adrenal dysfunction who were treated in the hospital from October 2010 to October 2011 were selected as study objects, and then they were randomly divided into control group and observation group, 50 children in each group. The children in control group were treated with routine therapy, such as antiviral therapy, reducing intracranial pressure, dimin- ishing inflammation with hormone, abatement of fever, and supporting treatment ; while the children in observation group were treated with intravenous injection of large - dose ACTH （250 I-tg/1.7 m2 ） based on the routine therapy used in control group. The curative effects in the two groups were evaluated, and the indexes of renal function in the two groups were compared. Results： The total effective rates in observa- tion group and control group were 98.0% and 72. 0%, respectively, there was statistically significant difference between the two groups （X^2 = 13. 254, P =0. 031 ） ; the increasing value of cortisol （Amax） in control group and observation group were （3.8 ±2. 1 ） μg/dL and （7. 1 ± 1.8）μg/dL, respectively, there was statistically significant difference between the two groups （t = 10. 184, P =0. 008） . Condu- sion ： Large - dose ACTH can significantly improve the curative effect of critically ill children with hand - foot - mouth disease, EV71 infec- tion combined with adrenal dysfunction, improve adrenal function, increase blood cortisol concentration, and relieve renal tissue damage or dysfunction, which has important value in clinical application.

关 键 词：大剂量ACTH EV71感染 手足口病 肾功能障碍 

分 类 号：R725.1[医药卫生—儿科]