乌司他丁对重症手足口病患儿的治疗疗效及血清白介素-6、白介素-10、肿瘤坏死因子-α的影响  

Effect of ulinastatin on therapeutic efficacy and serum interleukin-6,interleukin-10 and tumor necrosis factor-alpha in children with severe hand-foot-mouth disease

作　　者：黄敏菁[1] 蒙勇球 陆业光 龙飞[1] 刘文静[1] 陆兆美 

机构地区：[1]广西贵港市人民医院儿科重症监护病房,贵港市537100

出　　处：《广西医学》2016年第2期223-225,236,共4页Guangxi Medical Journal

摘　　要：目的探讨乌司他丁对重症手足口病患儿的治疗效果及血清白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的影响。方法重症手足口病患儿70例,其中治疗组35例,给予常规治疗并应用乌司他丁治疗;对照组35例,仅给予常规治疗,未用乌司他丁治疗。对比两组入院时及治疗5 d血清IL-6、IL-10、TNF-α水平和小儿危重评分(PCIS)、儿科重症监护病房(PICU)住院时间。结果入院时两组患儿IL-6、IL-10、TNF-α水平比较,差异无统计学意义(P>0.05);两组患儿治疗后IL-6、TNF-α水平均较入院时明显下降(P<0.05);治疗后治疗组血清IL-6、TNF-α水平明显低于对照组(P<0.05),IL-10水平较治疗前升高,且明显高于对照组(P<0.05)。两组患儿入院时PCIS比较,差异无统计学意义(P>0.05)。治疗后治疗组患儿PCIS明显高于入院时(P<0.05),但治疗后对照组患儿PCIS与入院时比较,差异无统计学意义(P>0.05)。治疗后治疗组患儿PCIS明显高于对照组(P<0.05)。治疗组PICU住院时间明显短于对照组(P<0.05)。结论乌司他丁能降低促炎因子IL-6、TNF-α的血清水平,促进抗炎因子IL-10的产生,对重症手足口病患儿的治疗效果较好,能明显改善病情,缩短PICU住院时间。Objective To explore the effect of ulinastatin on the therapeutic efficacy and serum interleukin-6（IL-6） ,interleukin-10 （IL-10） and tumor necrosis factor alpha（TNF-α） in children with hand-foot-mouth disease（HFMD）. Methods Of 70 children with severe HFMD,35 were enrolled as treatment group and were given conventional treatment and ulinastatin,and 35 were enrolled as control group and were given conventional treatment alone without ulinastatin. On admission and at 5 days after treatment, the serum levels of IL-6, IL-10, TNF-α, pediatric clinical illness score （PCIS） and hospital stay of pediatric intensive care unit （PICU） were compared between two groups. Results There was no significant difference in sermn levels of IL-6, IL-10 or TNF-α between two groups on admission （ P 〉 0.05 ）. The levels of IL-6 and TNF- α in the two groups were significantly lower after treatment compared to the levels on admission （ P 〈 0. 05 ）. After treatment,the serum levels of IL-6 and TNF- α were significantly lower in the treatment group compared to those in the control group,and the level of IL-10 was significantly higher in the treatment group compared to that before treatment or in the control group（P 〈0.05）. No significant difference in PCIS was found between two group on admission（P 〉0.05）. After treatment,the PICS of treatment group was significantly higher than that on admission（P 〈0. 05）. But no statistical difference was found between PCIS on admission and PCIS after treatment in the control group（P 〉0.05）. And the PICS of treatment group was significantly higher than that of control group after treatment（P 〈0.05）. The hospital stay of PICU was significantly shorter in the treatment group than that in the control group （ P 〈 0.05 ）. Conclusion Ulinastatin can reduce the serum levels of IL-6 and TNF-α,and promote the production of IL-10. It has a good therapeutic efficacy on children with HFMD,and can significantly improve the condition and shorte

关 键 词：手足口病 重症 乌司他丁 白介素-6 白介素-10 肿瘤坏死因子-α 疗效 

分 类 号：R512.57[医药卫生—内科学]