雾化吸入IFN-α1b对重症手足口病脑保护作用的研究  

Cerebral protective effect of aerosol inhalation of human recombinant interferon α1b on hand-foot-mouth disease with encephalitis

作　　者：张瑜[1] 谢燕[1] 袁娟[1] 符佳[1] 张玉凤[1] 杜嘉仪 

机构地区：[1]西安市儿童医院感染二科,陕西西安710003 [2]西安高新第一中学,陕西西安710119

出　　处：《中国妇幼健康研究》2017年第9期1071-1074,共4页Chinese Journal of Woman and Child Health Research

基　　金：陕西省科学技术研究发展资助项目(2011K12-82);西安市科学技术局医疗卫生研究资助项目(2016052 SF/YX08);陕西省科技统筹重点产业创新链工程计划资助项目(2016KTZDSF02-04)

摘　　要：目的通过检测患者血清C-反应蛋白(CRP)、神经特异性烯醇化酶(NSE)、S-100B蛋白浓度变化水平,研究雾化吸入重组干扰素α1b对手足口病(HFMD)合并脑炎患者脑组织的保护作用。方法选取2014年3月至2015年12月西安市儿童医院收治的手足口病患者合并脑炎100例,随机分为干扰素α1b组及常规治疗组各50例,两组均进行常规对症和支持治疗,干扰素α1b组在其基础上加用重组人干扰素α1b(IFN-α1b)注射液2~4μg/kg,雾化吸入,2次/日,连续治疗5天。于入院治疗后第1、3、5天通过酶联免疫吸附法(ELISA)检测治疗前后患者血清CRP、NSE和S-100B的浓度;另选同期在西安市儿童医院体检中心体检的健康儿童50例为对照组。结果 (1)与对照组相比,干扰素α1b组和常规治疗组血清CRP、NSE、S-100B浓度在各检测时间点均明显升高,差异均具有统计学意义(治疗后第1天,F值分别为28.632、52.378、20.451,均P<0.01;治疗后第3天,F值分别为35.257、61.954、29.153,均P<0.01;治疗后第5天,F值分别为31.569、55.634、24.657,均P<0.01);(2)与常规治疗组相比,干扰素α1b组在第3、5天血清NSE、S-100B浓度明显降低(第3天,t值分别为12.367、11.358,均P<0.05;第5天,t值分别为20.315、15.697,P<0.01),但干扰素α1b组和常规治疗组的CRP浓度在各检测时间点均无明显差别(第1天,t=1.236,P>0.05;第3天,t=1.529,P>0.05;第5天,t=1.637,P>0.05);(3)干扰素α1b组和常规治疗组连续治疗5天,血清CRP、NSE、S-100B浓度均呈现先升高后下降现象,于第3天达峰值,干扰素α1b组血清NSE、S-100B浓度下降更为显著。结论重组干扰素α1b可有效降低HFMD合并脑炎患儿外周血NSE和S-100B的浓度,对受损脑组织细胞具有保护作用。Objective To study the cerebral protective effect of aerosol inhalation of human recombinant interferon（ INF） α1b on handfoot-mouth disease（ HFMD） with encephalitis by detecting serum C-reactive protein（ CRP）,neuro-specific enolase（ NSE） and S-100 B concentrations in patients. Methods Totally 100 cases of HFMD with encephalitis were selected in Xi＇an Children＇s Hospital from March2014 to December 2015,and they were randomly divided into IFN-α1b group and conventional therapy group with 50 cases in each. All cases accepted conventional and support treatment. In INF-α1b group 2-4μg/kg INF-α1b injection was inhaled twice a day for 5 days.Serum CRP,NSE and S-100 B concentrations were detected by ELISA at 1d,3d and 5d after treatment. Another 50 healthy children taking physical examination in Xi＇an Children＇s Hospital in the same period were selected as healthy control group. Results Compared with the healthy control group,the concentrations of serum CRP,NSE and S-100 B in IFN-α1b group and the conventional treatment group were significantly increased at each testing time point（ 1d after treatment,F value was 28. 632,52. 378 and 20. 451,respectively,all P 0. 01; 3d after treatment,F value was 35. 257,61. 954 and 29. 153,respectively,all P 0. 01; 5d after treatment,F value was 31. 569,55. 634 and 24. 657,respectively,all P 0. 01）. Compared with the conventional treatment group,the concentrations of serum NSE and S-100 B decreased significantly in IFN-α1b group after treatment for 3 and 5 days（ 3d after treatment,t value was 12. 367 and 11. 358,respectively,both P 0. 05; 5d after treatment,t value was 20. 315 and 15. 697,respectively,both P 0. 01）. However,there was no significant difference in CRP concentration between IFN-α1b group and the conventional treatment group（ 1d after treatment,t = 1. 236; 3d after treatment,t = 1. 529; 5d after treatment,t = 1. 637,all P 0. 05）. During the continuous treatment for 5 days,the serum concentrations of CRP,NSE and S-100 B increased fi

关 键 词：手足口病合并脑炎 重组人干扰素Α1B C-反应蛋白 神经特异性烯醇化酶 S-100B蛋白 脑组织保护作用 

分 类 号：R725.1[医药卫生—儿科]