硫酸镁对重症手足口病患儿脑损伤的保护作用  

Protective effect of magnesium sulfate on brain injury in severe hand foot and mouth disease

作　　者：朱琳[1] 宋春兰 崔君浩 Zhu Lin;Song Chunlan;Cui Junhao(Children's Hospital Affiliated of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院重症监护室,河南郑州450000

出　　处：《中国现代医药杂志》2021年第3期15-18,共4页Modern Medicine Journal of China

基　　金：2017年度河南省医学科技攻关计划项目(编号:201702326)。

摘　　要：目的探讨硫酸镁对重症手足口病(HFMD)患儿脑损伤的保护作用。方法选取我院重症监护室于2016年3月~2018年12月收治的100例重症HFMD患儿作为研究对象,采用随机数表法将患儿分为对照组和观察组,每组50例。两组患儿均给予常规治疗,对照组在此基础上给予神经节苷脂治疗,观察组则给予硫酸镁治疗,7d为1个疗程。检测并比较两组患儿治疗前、治疗3d、治疗7d时的血清中枢神经特异性蛋白(S100β)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)的水平,同时比较两组患儿的临床疗效、住院时间、脑电图及头颅MRI检查结果。结果观察组患儿的治疗有效率为96.0%,明显高于对照组的66.0%,差异有统计学意义(P<0.05);治疗前,两组患儿的血清S100β、MBP、NSE水平比较差异均无统计学意义(P>0.05),治疗3d、7d后,观察组血清S100β、MBP、NSE水平均较对照组低,差异均有统计学意义(P<0.05);观察组患儿的住院时间为(7.13±2.43)d,明显短于对照组的(9.72±2.85)d,差异有统计学意义(P<0.05);观察组患儿头颅MRI及脑电图异常率分别为30.0%、34.0%,明显低于对照组的56.0%、60.0%,差异均有统计学意义(P<0.05)。结论硫酸镁可有效降低重症HFMD患儿血清S100β、MBP、NSE水平,缩短住院时间,提高临床疗效,有较好的脑保护作用,对病情的转归具有积极作用。Objective To investigate the protective effect of magnesium sulfate on brain injury in children with severe hand foot and mouth disease(HFMD).Methods A total of 100 children with severe HFMD admitted to the intensive care unit of our hospital from Mar 2016 to Dec 2018 were selected as research objects and randomly divided into control group and observation group,with 50 cases in each group.Children in both groups were given conventional treatment,the control group was given ganglioside treatment,the observation group was given magnesium sulfate treatment,7 d for a course of treatment.The levels of serum S100βprotein,myelin basic protein(MBP)and neuronal specific enolase(NSE)were measured and compared before treatment,3 days after treatment and 7 days after treatment,and the clinical efficacy,length of hospitalization,EEG and cranial MRI results of the two groups were also compared.Results The effective rate of treatment in the observation group was 96.0%,higher than 66.0%in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of serum S100βprotein,MBP and NSE between the two groups(P>0.05).3 days and 7 days after treatment,the levels of serum S100βprotein,MBP and NSE in the observation group were all decreased compared with the control group(P<0.05).The length of hospitalization in the observation group was(7.13±2.43)d,significantly shorter than(9.72±2.85)d in the control group.The abnormal rates of cranial MRI and EEG in the observation group were 30.0%and 34.0%,respectively,significantly lower than that in the control group(56.0%and 60.0%)(P<0.05).Conclusion Magnesium sulfate can effectively reduce the levels of serum S100βprotein,MBP and NSE in children with severe HFMD,shorten length of hospitalization,improve clinical efficacy,have a better brain protection effect,and play a positive role in the outcome of the disease.

关 键 词：硫酸镁 手足口病 脑损伤 保护作用 

分 类 号：R725.1[医药卫生—儿科]