早期足量甲泼尼龙联合丙种球蛋白治疗重型手足口病的临床研究  

Clinical research of early enough methylprednisone combined with immunoglobulin in treatments of children with severe hand,foot and mouth disease

作　　者：乐高钟[1] 吴小秧[1] 程均[1] 罗勤[1] 

机构地区：[1]江西省萍乡市人民医院儿科,萍乡337055

出　　处：《江西医药》2015年第4期286-289,共4页Jiangxi Medical Journal

基　　金：江西省卫生厅科技计划资助项目(20122071)

摘　　要：目的探讨早期足量使用甲泼尼龙联合丙种球蛋白治疗重型手足口病的临床疗效。方法选取本院2012年-2014年住院部重型手足口病患儿123例,随机分为4组。治疗1组(甲强)25例,治疗2组(静丙)30例,治疗3组(甲强+静丙)38例,对照组30例。4组年龄、性别及发病病程差异无统计学意义(P>0.05)。对照组给予一般常规治疗;治疗组在一般常规治疗基础上,治疗1组加用甲泼尼龙(甲强2mg/(kg·d),疗程3-5d);治疗2组加用丙种球蛋白(静丙1g/(kg·d),疗程2d);治疗3组联合甲强及静丙辅助治疗。4组同时配合控制颅内压、对症支持治疗,观察四组疗效。结果治疗3组(甲强+静丙)治愈率高于其他各组(P均<0.05);在发热消退时间、神经系统症状、临床治愈时间、无效或转危重型控制方面均优于其他各组(P<0.05),并未增加相关并发症。结论早期足量使用甲泼尼龙联合丙种球蛋白治疗重型手足口病疗效安全、有效,值得临床推荐使用。Objective To observe the efficacy of early enough methylprednisone combined with immunoglobulin in treatments of children with severe hand,foot and mouth disease. Methods From 2012 to 2014 in our hospital inpatient department in 123 children with Hand,Foot And Mouth Disease. The patients were divided into four group by random,the treatment group 1 of 25 cases,the treatment group 2 of 30 cases,the treatment group 3 of 38cases;30 cases in the control group. There was no significant statistical difference in age,sex and disease course among four grous （P〉0.05）. Patients of four groups all accepted symptomatic treatment,supportive therapy and the treatment of control intracranial pressure. And patients in treatment group 3 received the treatment of early,enough methylprednisone combined with immunoglobulin,the treatment group 1 with methylprednisone,the treatment group 2 with immunoglobulin,whereas patients in the control group were received conventional therapy. Results Cura-tive rate of the treatment group 3 was better than that of the other groups （P〈0.05）,otherwise incidence rate of critical illness was less than that of the other groups .The control time of fever,neurological symptoms,time of clinical cure was shorter than that of the other groups （P〈0.05）. and no more recent or long-term treatment-related adverse reaction in treatment group 3. Conclusion Early enough methylprednisone combined with immunoglobulin is safe effective,in treaing severe hand,foot and mouth disease, and worthy to recommend its clinical application.

关 键 词：甲泼尼龙 丙种球蛋白 重型手足口病 儿童 疗效 

分 类 号：R512.5[医药卫生—内科学]