甲泼尼龙琥珀酸钠联合免疫球蛋白治疗小儿重症传染性单核细胞增多症的临床研究  

Methylprednisolone Sodium Succinate Combined with Immunoglobulin in the Treatment of Severe Infectious Mononucleosis in Children

作　　者：王晓娟[1] 贾莉[1] 刘俊莹[1] 田方成 李文辉[1] WANG Xiaojuan;JIA Li;LIU Junying;TIAN Fangcheng;LI Wenhui(Dept.of Infectious Disease,Children’s Hospital of Hebei Province,Hebei Shijiazhuang 050000,China)

机构地区：[1]河北省儿童医院感染科,河北石家庄050000

出　　处：《中国医院用药评价与分析》2021年第12期1441-1444,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究课题计划项目(No.20200670)。

摘　　要：目的:探讨甲泼尼龙琥珀酸钠联合免疫球蛋白治疗小儿重症传染性单核细胞增多症的临床疗效。方法:选取2018年3月至2021年1月河北省儿童医院收治的小儿重症传染性单核细胞增多症患者96例,按照随机数字表法分为对照组和研究组,每组48例。对照组患儿接受常规治疗,研究组患儿采用注射用甲泼尼龙琥珀酸钠联合人免疫球蛋白治疗。观察两组患儿的疗效、临床症状消退时间、T淋巴细胞亚群比例、血清生化指标及不良反应发生情况。结果:与对照组的总有效率(70.83%,34/48)相比,研究组患儿的总有效率(93.75%,45/48)明显更高,差异有统计学意义(P <0.05)。研究组患儿治疗后的CD8^(+)水平明显低于对照组,CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平明显高于对照组,差异均有统计学意义(P <0.05)。研究组患儿治疗后的C反应蛋白水平、白细胞计数、异型淋巴细胞比例、丙氨酸转氨酶水平、肌酸激酶同工酶水平和EB DNA载量明显低于对照组,差异均有统计学意义(P <0.05)。研究组、对照组患儿的不良反应发生率为16.67%(8/48)、8.33%(4/48),差异无统计学意义(P> 0.05)。与对照组相比,研究组患儿的咽峡炎消退时间、退热时间、肝脾肿大消退时间和淋巴结消退时间明显缩短,差异均有统计学意义(P<0.05)。结论:甲泼尼龙琥珀酸钠联合免疫球蛋白治疗小儿重症传染性单核细胞增多症,可促进患儿症状改善,提高免疫功能,改善血清生化指标,安全可靠。OBJECTIVE: To probe into the clinical efficacy of methylprednisolone sodium succinate combined with immunoglobulin in the treatment of severe infectious mononucleosis in children. METHODS: Totally 96 children with severe infectious mononucleosis admitted into Children’s Hospital of Hebei Province from Mar. 2018 to Jan. 2021 were selected and divided into control group and research group via random number table,with 48 cases in each group. The control group was given conventional therapy,while the research group was given methylprednisolone sodium succinate combined with immunoglobulin. The clinical efficacy,remission time of clinical symptoms,proportions of T lymphocyte subpopulation,serum biochemical indicators and incidences of adverse drug reactions of the two groups were observed.RESULTS: Compared with the total effective rate of 70. 83%( 34/48) in the control group,that of the research group( 93. 75%,45/48) was significantly higher,with statistically significant difference( P <0. 05). The research group had significantly lower CD8^(+)and significantly higher CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)than the control group after treatment,with statistically significant differences( P < 0. 05). The C-reactive protein,while blood cell count,proportion of heterolymphocyte,alanine aminotransferase,creatine kinase isoenzyme and loading capacity of EB DNA of research group were significantly lower than those of the control group,with statistically significant differences( P < 0. 05). The incidences of adverse drug reactions of research group and control group were respectively 16. 67%( 8/48) and 8. 33%( 4/48),the difference was not statistically significant( P > 0. 05). Compared with the control group,the remission times of angina,fever,hepatosplenomegaly and lymph gland of research group were significantly shorter,with statistically significant differences( P < 0. 05). CONCLUSIONS: The combination of methylprednisolone sodium succinate and immunoglobulin in the treatment of severe infectious mononucleosis in children ca

关 键 词：糖皮质激素 免疫球蛋白 小儿重症传染性单核细胞增多症 疗效 

分 类 号：R977.1[医药卫生—药品] R985[医药卫生—药学]