米力农注射液联合甲基泼尼松龙注射液治疗手足口病合并脑炎患儿的临床研究  

Clinical trial of milrinone injection combined with methylprednisolone injection in the treatment of children with hand-foot-and-mouth disease combined with encephalitis

作　　者：姜波[1] 

机构地区：[1]贵州医科大学附属黔东南州人民医院感染科,贵州凯里556000

出　　处：《中国临床药理学杂志》2016年第20期1848-1851,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家"重大新药创制"科技重大专项基金资助项目(2011ZX09303-001)

摘　　要：目的观察米力农联合甲基泼尼松龙治疗手足口病合并脑炎患儿的临床疗效及作用机制。方法 86例手足口病合并脑炎患儿随机分为对照组43例和试验组43例。对照组用米力农治疗,首次剂量为0.5 mg·kg^(-1),于5~10 min匀速静脉推注,之后每分钟0.25~1.0 mg·kg^(-1)等量维持,持续治疗1~3 d。试验组在对照组的基础上每天静脉滴注甲基泼尼松龙1.0~3.0 mg·kg^(-1),持续治疗3~5 d。观察2组患者的症状消失时间、临床疗效及治疗前后血清白细胞介素(IL)-6、IL-12及干扰素-γ(INF-γ)水平。结果治疗后,试验组和对照组的总有效率分别为95.35%(41/43例)和72.09%(31/43例),差异有统计学意义(P<0.05)。试验组和对照组的发热消失时间分别为(3.01±0.32),(4.23±0.35)d;皮疹消失时间分别为(6.13±0.96),(8.67±1.02)d;意识模糊消失时间分别为(1.26±0.15),(2.01±0.23)d;血压异常消失时间分别为(4.03±0.62),(6.31±0.78)d;面色苍灰消失时间分别为(2.49±0.36),(4.58±0.42)d;脉搏浅速或减弱症状消失时间分别为(4.12±0.65),(7.05±0.83)d,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组的血清IL-6分别为(123.46±10.53),(132.68±10.49)ng·L^(-1);IL-12分别为(61.76±5.43),(68.79±5.61)ng·L^(-1);IFN-γ分别为(46.67±3.88),(49.32±3.96)ng·L^(-1),差异均有统计学意义(P<0.05)。2组均未出现药物不良反应。结论米力农联合甲基泼尼松龙治疗手足口病合并脑炎患儿临床疗效显著,能够显著下调血清IL-6、IL-12、IFN-γ水平。Objective To evaluated the clinical effect of milrinone combined with methylprednisolone in the treatment of children with hand-foot-and-mouth disease combined with encephalitis and its mechanism.Methods Eighty-six children with hand-foot-and-mouth disease combined with encephalitis were randomly divided into treatment group and control group,with 43 cases in each group.The control group were treated with milrinone,firstly 0.5 mg · kg^（-1）,in uniform 5-10 min vein injection,after a minute 0.25-1.0 mg·kg^（-1）equal to maintain for 1-3 d.The treatment group was given methylprednisolone 1.0-3.0 mg·kg^（-1）based on the control group,intravenous drips for 3-5 d.The changes of serum interleukin-6（IL-6）,interleukin-12（IL-12） and interferon-γ（INF-γ） levels of the two groups were compared and the symptoms disappearance time,clinical effect were observed.Results The total effective rate in treatment group was 95.35%（41/43）,with significant difference with 72.09%（31/43） in control group（P 0.05）.The disappearance time of symptoms such as fever,rash,blurred consciousness,abnormal blood pressure,pale gray,superficial pulse or weakened in treatment group were respectively（3.01 ± 0.32）,（6.13 ± 0.96）,（1.26 ± 0.15）,（4.03 ± 0.62）,（2.49 ± 0.36）,（4.12 ± 0.65）d,with significant difference with those in control group,which were（4.23 ± 0.35）,（8.67 ± 1.02）,（2.01 ± 0.23）,（6.31 ± 0.78）,（4.58 ± 0.42）,（7.05 ± 0.83） d（P 0.05）.After treatment,the serum IL-6,IL-12 and IFN-γ levels in treatment group were respectively（123.46 ± 10.53）,（61.76 ± 5.43）,（46.67 ± 3.88）ng·L^（-1）,had significant difference with（132.68 ± 10.49）,（68.79 ± 5.61）,（49.32 ± 3.96） ng·L^（-1）in control group（P 0.05）.There was no adverse drug reactions in two groups.Conclusion The clinical effect of milrinone combined with methylprednisolone in the treatment of hand-foot-and-mouth disease complicated with encephalitis is significant

关 键 词：米力农 甲基泼尼松龙 手足口病 白细胞介素-6 白细胞介素-12 干扰素-Γ 

分 类 号：R97[医药卫生—药品]