亚低温联合咪达唑仑对重症病毒性脑炎患儿血清β-EP、NSE水平的影响  

Effect of mild hypothermia combined with midazolam on serum β-EP and NSE levels in children with severe viral encephalitis

作　　者：何双龙[1] 许健健[2] 

机构地区：[1]河间市人民医院儿科,河北沧州062450 [2]合肥工业大学控释药物研究所,安徽合肥230009

出　　处：《中国妇幼保健》2016年第5期1065-1068,共4页Maternal and Child Health Care of China

基　　金：国家科技支撑计划项目(2012BAI01B00)

摘　　要：目的探讨亚低温联合咪达唑仑治疗重症病毒性脑炎患儿的临床疗效以及对患儿血清β内啡肽(β-EP)、神经元特异性烯醇化酶(NSE)水平的影响。方法采用随机数字法将50例重症病毒性脑炎患儿分为观察组和对照组各25例,所有患儿均给予抗病毒、降低颅内压等基础支持治疗,观察组在基础支持治疗的基础上给予亚低温联合咪达唑仑治疗,对比和观察两组治疗后临床疗效、不良反应发生以及血清β-EP和NSE水平变化。结果观察组治疗后的临床总有效率显著高于对照组(P<0.05),而不良反应发生率、体温恢复正常、惊厥消失、肢体瘫痪消失、昏迷恢复时间均显著低于对照组(P<0.05);观察组和对照组血清β-EP、NSE水平均随治疗时间延长而逐渐下降(P<0.05),其中观察组治疗第5天和第10天血清β-EP、NSE水平均显著低于对照组(P<0.05)。结论亚低温联合咪达唑仑治疗重症病毒性脑炎患儿的临床疗效显著,总有效率高且不良反应发生较少,同时还可抑制体内β-EP和NSE水平释放,保护患儿神经功能受到继发性损害。Objective To explore the clinical effect of mild hypothermia combined with midazolam in treatment of children with severe viral encephalitis and its impact on serum β-endorphin （β-EP） and neuron-specific enolase （NSE） levels. Methods Fifty children with severe viral encephalitis were divided into observation group and control group by random number table, 25 children in each group. All the children were treated with anti-viral therapy, decreasing intracranial pressure, and other basic supportive treatment, the children in observation group were treated with mild bypothermia combined with midazolam based on basic supportive treatment. The clinical effects, adverse reactions, and changes of serum β-EP and NSE levels in the two groups were compared and observed. Results The total clinical efficiency in observation group was statistically significantly higher than that in control group （ P〈0. 05 ） , while the incidence rates of adverse reactions, the time of body temperature return to normal, disappearance time of convulsion, disappearance time of limb paralysis, recovery time of coma in observation group were statistically significantly lower than those in control group （ P〈0. 05 ） ; the levels of serum β-EP and NSE in observation group and control group decreased gradually with treatment time （P〈0. 05 ） , the levels of serum β-EP and NSE on the fifth day and the tenth day after treatment in observation group were statistically significantly lower than those in control group （P〈0. 05 ） . Conclusion The clinical effect of mild hypothermia combined with midazolam in treatment of children with severe viral encephalitis is significant, the total clinical efficiency is high and the incidence rates of adverse reactions are relatively low, the therapy can inhibit the release of β-EP and NSE and protect nerve function of the children from secondary damage.

关 键 词：病毒性脑炎 亚低温 咪达唑仑 Β内啡肽 神经元特异性烯醇化酶 

分 类 号：R512.3[医药卫生—内科学]