病毒唑联合炎琥宁治疗手足口病患儿的效果及其对T淋巴细胞亚群水平的影响  

Effect of ribavirin combined with Yanhuning on children with HFMD and its effect on T lymphocyte subsets

作　　者：肖耿吉[1] 廖亦男[1] 刘芙蓉[1] 姚婷新[1] 于四景[1] Xiao Gengji;Liao Yinan;Liu Furong;Yao Tingxin;Yu Sijing(Department of Infectious Disease,Hunan Children's Hospital,Hunan Province,Changsha 410007,China)

机构地区：[1]湖南省儿童医院感染科

出　　处：《疑难病杂志》2020年第1期71-74,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察病毒唑联合炎琥宁治疗手足口病患儿效果及其对T淋巴细胞亚群水平的影响。方法选取2018年3月-2019年3月湖南省儿童医院感染科治疗手足口病患儿110例作为研究对象,随机数字表法分为2组各55例,炎琥宁组使用炎琥宁进行治疗,联合组使用病毒唑联合炎琥宁进行治疗,治疗5 d后,比较2组患儿临床症状消退时间,酶法速率法检测肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)水平,酶联免疫吸附试验法检测血清白细胞介素-4(IL-4)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平,使用流式细胞仪检测T淋巴细胞亚群水平,比较2组治疗效果及不良反应发生情况。结果联合组患儿治疗总有效率显著高于炎琥宁组(94.55%vs.81.82%,χ~2/P=4.274/0.039);治疗后,联合组患儿发热、手足疱疹、口腔溃疡消退时间均短于炎琥宁组(t=9.424、7.806、6.523,P均=0.001);血清CK、LDH、CK-MB、IL-4、hs-CRP、TNF-α、CD8^+水平均低于炎琥宁组(t=3.698、2.894、5.445、4.233、6.882、5.672、5.161,P<0.01),CD4^+、CD3^+水平高于炎琥宁组(t/P=5.444/0.001、4.079/0.001);不良反应发生率略高于炎琥宁组,但差异无统计学意义(P>0.05)。结论病毒唑联合炎琥宁治疗手足口病,可加快患儿临床症状消退速度,改善心肌酶水平,抑制炎性反应,提升免疫功能,治疗效果显著。Objective To observe the effect of ribavirin combined with Yanhuning in the treatment of HFMD and its effect on T lymphocyte subsets.Methods From March 2018 to March 2019,110 children with HFMD were selected as the subjects of study.Randomly divided into two groups of 55 cases each.Yanhuning group was treated with Yanhuning,and the combination group was treated with Virazole and Yanhuning.After 5 days of treatment,the clinical symptoms of the two groups were compared.The levels of creatine kinase(CK),lactate dehydrogenase(LDH) and creatine kinase isoenzyme(CK-MB)were measured by enzyme-linked immunosorbent assay.The levels of serum interleukin-4(IL-4),high-sensitivity C-reactive egg white(hs-CRP) and tumor necrosis factor-α(TNF-α) were measured by flow cytometry Cell subpopulation level.The therapeutic effect and adverse reactions were compared between the two groups.Results The total effective rate of children in the combination group was significantly higher than that in the Yanhuning group(94.55% vs.81.82%,χ~2/P=4.274/0.039).After treatment,the duration of fever,herpes,and oral ulcer subsided in the combined group was shorter than that in the Yanhuning group(t=9.424,7.806,6.523,P=0.001).Serum CK,LDH,CK-MB,IL-4,hs-CRP,TNF-α,CD8^+levels were lower than those in the Yanhuning group(t/P=3.698/0.001,2.894/0.001,5.445/0.001,4.233/0.001,6.882/0.001,5.672/0.001,5.161/0.001),CD4^+and CD3^+levels were higher than those in the Yanhuning group(t/P=5.444/0.001,4.079/0.001).The incidence of adverse reactions was slightly higher than that in the Yanhuning group,but the difference was not statistically significant(P>0.05).Conclusion Virazole combined with Yanhuning in the treatment of HFMD can accelerate the regression of clinical symptoms,improve the level of myocardial enzymes,inhibit inflammatory response,improve immune function,and have a significant therapeutic effect.

关 键 词：病毒唑 炎琥宁 手足口病 免疫功能 T淋巴细胞 

分 类 号：R725.1[医药卫生—儿科]