静注人免疫球蛋白对EV71型感染重症手足口病患儿炎症因子、免疫功能的影响  

Effect of human immunoglobulin injection on inflammatory factors and immune function in children with severe hand-foot-mouth disease caused by EV71 infection

作　　者：谢曼芬 高燕 蔡晨露 王肖 郭会敏 Xie Manfen;Gao Yan;Cai Chenlu;Wang Xiao;Guo Huimin(Department of Outdoor Emergency,Hainan Women and Children's Medical Center,Haikou 570000,China)

机构地区：[1]海南省妇女儿童医学中心门急诊科,海口570000

出　　处：《中华临床医师杂志（电子版）》2022年第2期136-140,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：海南省卫生健康行业科研项目(20A200190)。

摘　　要：目的探究静注人免疫球蛋白联合常规治疗肠道病毒71(EV71)型感染重症手足口病患儿疗效及对炎症因子、免疫功能的影响。方法选择2018年12月至2020年12月在海南省妇女儿童医学中心进行治疗的EV71型感染重症手足口病患儿126例,采用随机数字表法分为对照组和观察组,每组各63例。对照组进行常规治疗,观察组在对照组的基础上进行静注人免疫球蛋白治疗。对比2组治疗有效率、临床症状改善时间、血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-17(IL-17)、白介素-10(IL-10)、生长转化因子β_(1)(TGF-β_(1))]及外周血T淋巴细胞亚群水平,并观察记录不良反应发生情况。结果观察组临床总有效率为87.30%,高于对照组的69.84%(P<0.05);观察组体温复常时间、皮疹及口腔溃疡消退时间均短于对照组(P<0.05);治疗后,观察组血清CRP、IL-6、TNF-α、IL-17水平低于对照组(P<0.05);治疗后,观察组IL-10、TGF-β_(1)水平高于对照组(P<0.05);治疗后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组(P<0.05);2组患儿在治疗期间未出现药物不良反应。结论静注人免疫球蛋白联合常规治疗EV71型感染重症手足口病患儿具有较高的临床疗效,能够促进症状恢复,可能与降低炎症反应、提高免疫功能相关。Objective To evaluate the efficacy of human immunoglobulin injection combined with conventional treatment in children with severe hand-foot-mouth disease caused by enterovirus 71(EV71)infection and explore the influence on inflammatory factors and immune function.Methods One hundred and twenty-six children with severe hand-foot-mouth disease caused by EV71 infection who were treated at Hainan Women and Children's Medical Center between December 2018 and December 2020 were selected and divided into either a control group or an observation group using the random number table method,with 63 cases in each group.Both groups received conventional treatment,and the observation group was additionally given human immunoglobulin injection.The effective rate of treatment,time to improvement of clinical symptoms,levels of serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-17(IL-17),interleukin-10(IL-10),and transforming growth factorβ_(1)(TGF-β_(1))],and peripheral blood T lymphocyte subsets were compared between the two groups,and the occurrence of adverse reactions was recorded.Results The total clinical effective rate of the observation group was significantly higher than that of the control group(87.30%vs 69.84%,P<0.05).The time to normal recovery of normal body temperature and the time to disappearance of skin rash and oral ulcers in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the levels of serum CRP,IL-6,TNF-α,and IL-17 in the observation group were lower than those in the control group(P<0.05),while the levels of IL-10 and TGF-β_(1) were higher than those in the control group(P<0.05).After treatment,the proportions of CD3^(+) Tcells,CD4^(+) Tcells,and CD4^(+)/CD8^(+) Tcell ratio of the observation group were higher than those of the control group,while the proportion of CD8^(+) Tcells was lower than that of the control group(P<0.05).There were no adverse drug reactions in either group durin

关 键 词：肠道病毒71 手足口病 静注人免疫球蛋白 炎症因子 免疫功能 

分 类 号：R512.5[医药卫生—内科学]