甲泼尼龙联合地塞米松治疗小儿组织细胞坏死性淋巴结炎合并巨噬细胞活化综合征的效果分析  

Effectiveness Analysis of Methylprednisolone Combined with Dexamethasone in the Treatment of Pediatric Histiocytic Necrotizing Lymphadenitis Combined with Macrophage Activation Syndrome

作　　者：马辰晖 李福海[1] Ma Chenhui;Li Fuhai(Shandong University Qilu Hospital,Jinan 250012,Shandong Province,China)

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《中外医药研究》2024年第19期9-11,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析甲泼尼龙联合地塞米松治疗小儿组织细胞坏死性淋巴结炎(HNL)合并巨噬细胞活化综合征(MAS)的效果。方法:选取2019年1月—2023年12月山东大学齐鲁医院收治的HNL合并MAS患儿72例为观察对象,根据随机数字表法分为对照组与观察组,各36例。对照组给予甲泼尼龙治疗,观察组给予甲泼尼龙联合地塞米松治疗。比较两组血清指标、症状评分、免疫指标。结果:治疗前,两组红细胞沉降率(ESR)、肿瘤坏死因子(TNF-α)、白细胞计数(WBC)水平比较,差异无统计学意义(P>0.05);治疗后,两组ESR、TNF-α水平降低,WBC水平升高,观察组优于对照组,差异有统计学意义(P<0.05)。治疗前,两组发热、淋巴结肿大、皮疹评分比较,差异无统计学意义(P>0.05);治疗后,两组发热、淋巴结肿大、皮疹评分降低,观察组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)水平比较,差异无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)水平升高,CD8^(+)水平降低,观察组优于对照组,差异有统计学意义(P<0.05)。结论:甲泼尼龙联合地塞米松治疗小儿HNL合并MAS的效果显著,可减轻炎性反应,缓解临床症状,调节免疫功能。Objective:To analyze the effect of methylprednisolone combined with dexamethasone in the treatment of pediatric histiocytic necrotizing lymphadenitis(HNL)combined with macrophage activation syndrome(MAS).Methods:Seventy-two children with HNL combined with MAS admitted to Shandong University Qilu Hospital from January 2019 to December 2023 were selected for observation,and were divided into the control group and the observation group according to the randomized numerical table method,each with thirty-six cases.The control group was treated with methylprednisolone,and the observation group was treated with methylprednisolone combined with dexamethasone.The serum indexes,symptom scores,and immune indexes of the two groups were compared.Results:Before treatment,the levels of erythrocyte sedimentation rate(ESR),tumor necrosis factor(TNF-α),and white blood cell count(WBC)were compared between the two groups,and the difference was not statistically significant(P>0.05);after treatment,the levels of ESR and TNF-αwere decreased and the levels of WBC were increased in the two groups,and the observation group was better than the control group,and the difference was statistically significant(P<0.05).Before treatment,fever,lymph node enlargement and rash scores were compared between the two groups,and the difference was not statistically significant(P>0.05);after treatment,fever,lymph node enlargement and rash scores were reduced in the two groups,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Before treatment,the levels of CD3^(+),CD4^(+)and CD8^(+)were compared between the two groups,and the difference was not statistically significant(P>0.05);after treatment,the levels of CD3^(+)and CD4^(+)increased and the level of CD8^(+)decreased in the two groups,and the observation group was better than the control group,and the difference was statistically significant(P<0.05).Conclusion:Methylprednisolone combined with dexamethasone is effective in the treatment of

关 键 词：组织细胞坏死性淋巴结炎 巨噬细胞活化综合征 甲泼尼龙 地塞米松 

分 类 号：R725.5[医药卫生—儿科]