丙种球蛋白治疗对重症手足口病患儿血清BNP、NSE的影响  

Effect of γ-immunoglobulin treatment on serum BNP and NSE in children with severe hand-foot-mouth disease

作　　者：朱学龙 余国庆 ZHU Xue-long;YU Guo-qing(Maigaoqiao Branch,Second Affiliated Hospital of Nanjing Medical University,Nanjing,210028 China)

机构地区：[1]南京医科大学第二附属医院迈皋桥院区,210028 [2]安徽省芜湖海螺庆院,100142

出　　处：《中国实用医药》2019年第35期6-9,共4页China Practical Medicine

摘　　要：目的探讨丙种球蛋白对重症手足口病患儿血清脑钠肽(BNP)、神经元特异性烯醇化酶(NSE)的影响。方法 81例重症手足口病患儿,按照治疗方式不同分为A组(44例)、B组(37例),另选取同期健康体检儿童36例作为C组。B组给予常规治疗, A组在B组基础上给予常规剂量人血丙种球蛋白治疗,观察比较治疗前三组BNP、NSE水平,比较A组、B组治疗前后BNP、NSE水平、差值、患儿住院时间及转归情况。结果 A组治疗后BNP[56.565(29.232, 79.090)]ng/L、NSE[7.415(5.040,8.783)]μg/L值均低于治疗前的[137.520(76.730, 301.120)]ng/L、[16.380(8.690, 28.130)]μg/L,差异有统计学意义(P<0.05);B组治疗后BNP[83.920(32.810, 162.030)]ng/L、NSE[7.560(6.020, 9.070)]μg/L值均低于治疗前的[167.510(32.860, 321.810)]ng/L、[17.310(10.030, 21.750)]μg/L,差异有统计学意义(P<0.05);A组BNP、NSE下降较B组更显著,差异有统计学意义,(P<0.05);且A组患儿住院时间明显短于B组患儿,差异有统计学意义(P<0.05)。A、B组患儿最终经治疗均顺利痊愈出院。1例脑炎患儿出院时留有局部肢体障碍,转入康复科。结论重症手足口病患儿血清BNP、NSE升高明显,且使用丙种球蛋白辅助治疗重症手口足病患儿,可明显降低重症手足口病患儿血清BNP、NSE水平,缩短住院时间,具有较好的临床效果,且血清BNP、NSE水平能准确反映病情变化。Objective To discuss the effect of γ-immunoglobulin treatment on serum brain natriuretic peptide(BNP) and neurone specific enolase(NSE) in children with severe hand-foot-mouth disease. Methods A total of 81 children with severe hand-foot-mouth disease were divided into group A(44 cases) and group B(37 cases) by different treatment methods. Another 36 healthy children in the same period were selected as groupC. Group B received conventional therapy, and group A received conventional dose of human γ-immunoglobulin on the basis of group B. The BNP and NSE levels of the three groups before treatment was observed and compared, and the BNP and NSE levels and differences between group A and group B, hospitalization time and outcome of the three groups was compared. Results After treatment, the BNP[56.5650(29.2320, 79.090)] ng/L and NSE [7.4150(5.040, 8.7830)] μg/L in group A was lower than those before treatment [137.520(76.730, 301.120)] ng/L and [16.380(8.690, 28.130)] μg/L, and their difference was statistically significant(P<0.05). After treatment, BNP [83.920(32.810, 162.030)] ng/L and NSE [7.560(6.020, 9.070)] μg/L in group B was lower than those before treatment [167.510(32.860, 321.810)] ng/L and [17.310(10.030, 21.750)] μg/L, and their difference was statistically significant(P<0.05). The decrease of BNP and NSE in group A was more significant than that in group B, and the difference was statistically significant(P<0.05). The hospitalization time in group A was obviously shorter than that in group B, and the difference was statistically significant(P<0.05). The patients in group A and group B were cured and discharged after treatment. 1 child with encephalitis was transferred to rehabilitation department with local limb disorder. Conclusion Serum BNP and NSE are significantly elevated in children with severe hand-foot-mouth disease, and adjuvant therapy with human γ-immunoglobulin shows good clinical effect, and it can obviously reduce the serum BNP and NSE level of children, shorten the hospitalization

关 键 词：重症手足口病 静脉丙种球蛋白 脑钠肽 神经元特异性烯醇化酶 儿童 

分 类 号：R54[医药卫生—心血管疾病]