血浆置换术辅助丙种球蛋白在小儿病毒性脑炎治疗中的应用  

Application of plasma exchange assisted with immunoglobulin in the children with viral encephalitis

作　　者：韩东月 米艺果 HAN Dongyue;MI Yiguo(Department of Pediatrics,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿科,南阳473000

出　　处：《华夏医学》2024年第5期137-142,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202202310)。

摘　　要：目的观察血浆置换术辅助丙种球蛋白短程强化疗法对小儿病毒性脑炎的应用效果。方法选取113例病毒性脑炎患儿作为研究对象,按照计算机随机分组法将患者分为常规组56例和置换组57例。常规组予以常规治疗及丙种球蛋白短程强化治疗,置换组在常规组的治疗基础上,联合实施血浆置换术治疗,比较两组患儿的炎症反应、免疫功能、神经功能及治疗安全性。结果治疗后,置换组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)的水平均低于常规组,差异具有统计学意义(P<0.05);免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)的水平均高于常规组(P<0.05);神经元轴突轻链(NF-L)、中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)的水平均低于常规组(P<0.05)。置换组不良事件发生率略高于常规组,但无统计学差异(P>0.05)。结论血浆置换术辅助丙种球蛋白能改善病毒性脑炎患儿的炎症反应和神经功能,并增强免疫功能,安全性较高。Objective To observe the application effects of plasma exchange assisted with short-term immunoglobulin reinforcement therapy in the children with viral encephalitis.Methods 113 children with viral encephalitis were selected as the research subjects.The children were randomly divided into the conventional group(56 cases)and replacement group(57 cases).The patients in the conventional group were received routine treatment and short-term intensified treatment with immunoglobulin,while the patients in the replacement group were received plasma exchange surgery in combination with the conventional group.The inflammatory response,immune function,neurological function,and treatment safety of children were compared between the two groups.Results The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)in replacement group were lower than those in conventional group,showing a statistically significant difference(P>0.05).Immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)were higher than those in conventional group(P>0.05).The axonal light chain(NF-L),central nerve specific protein(S100β)and neuron-specific enolase(NSE)were lower than those in conventional group(P<0.05).The incidence of adverse events was slightly higher than that in conventional group(P>0.05).Conclusion Plasma exchange assisted with immunoglobulin improves the inflammatory response and neurological function in children with viral encephalitis,and enhances immune function,with high safety.

关 键 词：小儿病毒性脑炎 丙种球蛋白 血浆置换术 治疗效果 治疗安全性 

分 类 号：R72[医药卫生—儿科]