大剂量丙种球蛋白治疗小儿急性重症病毒性心肌炎的效果分析  

Effect of high-dose gamma globulin on acute severe viral myocarditis in children

作　　者：周英杰 魏克伦[2] ZHOU Yingjie;WEI Kelun(Shenyang Children′s Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市儿童医院重症医学科,沈阳110000 [2]中国医科大学附属盛京医院新生儿科

出　　处：《中国中西医结合儿科学》2022年第3期235-238,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：2018年辽宁省自然科学基金指导计划(20180550936)。

摘　　要：目的探究大剂量丙种球蛋白在小儿急性重症病毒性心肌炎治疗中的应用效果。方法选择我院2016年1月至2021年1月收诊的小儿急性重症病毒性心肌炎患儿94例为研究对象,随机分为对照组和观察组各47例。对照组给予常规治疗,观察组在对照组治疗基础上应用大剂量丙种球蛋白400 mg/(kg·d)静脉滴注,每日1次,连续治疗2周。对比两组的治疗总有效率、心肌酶谱、不良反应。结果观察组患儿治疗总有效率为93.62%(44/47),高于对照组76.60%(36/47),差异有统计学意义(P<0.05)。观察组患儿治疗后心肌酶谱肌酸激酶、肌酸激酶同工酶、乳酸脱氢酶水平均低于对照组,差异有统计学意义(P<0.05)。观察组患儿治疗后CD3^(+)、CD8^(+)均高于对照组,且CD4^(+)低于对照组,差异有统计学意义(P<0.05)。两组均未出现明显不良反应。结论大剂量丙种球蛋白在小儿急性重症病毒性心肌炎治疗中的应用效果肯定,有助于促进患儿免疫功能改善和心肌酶谱的改善,促进患儿早日康复,值得推广。Objective To explore the effect of high-dose gamma globulin in the treatment of acute severe viral myocarditis in children.Methods A total of 94 children with acute severe viral myocarditis admitted to our hospital from January 2016 to January 2021 were included as research subjects,and they were randomly divided into control group and observation group,with 47 in each group.The control group was given conventional treatment,and the observation group was additionally given intravenous infusion of large-dose gamma globulin[400 mg/(kg·d)],once a day,for 2 consecutive weeks.The total effective rate,myocardial enzyme spectrum and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 93.62%(44/47),higher than 76.60%(36/47)in the control group,and the difference was statistically significant(P<0.05).The levels of creatine kinase,creatine kinase isoenzyme and lactate dehydrogenase in the observation group were significantly lower than those in the control group(P<0.05).After treatment,CD3^(+)and CD8^(+)in the observation group were higher than those in the control group,and CD4^(+)was lower,the difference being statistically significant(P<0.05).There were no obvious adverse reactions in both groups.Conclusion The application effect of large dose gamma globulin in the treatment of acute severe viral myocarditis in children is definite,which is helpful to improve the immune function and myocardial enzyme spectrum of children,and promote the early recovery of children,so it is worthy of promotion.

关 键 词：急性重症病毒性心肌炎 丙种球蛋白 心肌酶谱 免疫功能 儿童 

分 类 号：R725.4[医药卫生—儿科]