摘要
目的观察甲泼尼龙琥珀酸钠联合重组人干扰素α1b治疗婴幼儿重症手足口病的临床效果及安全性。方法选取2022年1月—2024年3月贵航贵阳医院收治的重症手足口病患儿197例,采用随机数字表法分为观察组98例和对照组99例。在常规治疗基础上,对照组予以注射用重组人干扰素α1b治疗,观察组在对照组基础上加用注射用甲泼尼龙琥珀酸钠治疗,2组疗程为5 d。比较2组患儿临床疗效、临床症状消失时间、住院时间,治疗前后心肺功能指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心率(HR)、左室射血分数(LVEF)、心输出量(CO)与动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、炎性指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、核因子κB(NF-κB)、白介素-6(IL-6)及白介素-10(IL-10)],不良反应。结果观察组治疗总有效率高于对照组(86.73%vs.75.76%,χ^(2)=3.89,P=0.049);观察组退热时间、口腔疱疹消失时间、住院时间均短于对照组(P<0.01),但2组皮损消失时间比较差异无统计学意义(P>0.05)。治疗5 d后,对照组CO较治疗前无统计学差异,2组CK、CK-MB、HR、LVEF、PaO_(2)、PaCO_(2)均较治疗得到明显改善,且观察组改善程度大于对照组(P<0.01);2组CRP、NF-κB、TNF-α、IL-6及IL-10水平均较治疗前下降,且观察组低于对照组(P<0.01)。观察组与对照组不良反应总发生率比较,差异无统计学意义(37.76%vs.25.25%,χ^(2)=3.569,P=0.059)。结论甲泼尼龙琥珀酸钠联合重组人干扰素α1b治疗婴幼儿重症手足口病的疗效确切,可有效改善婴幼儿临床症状及心肺功能,减轻炎性反应,且安全性高。
Objective To observe the clinical efficacy and safety of methylprednisolone sodium succinate combined with recombinant human interferonα1b in the treatment of severe hand,foot and mouth disease in infants.Methods A total of 197 children with severe HFMD admitted to Guihang Guiyang Hospital from January 2022 to March 2024 were enrolled and divided into the observation group(98 cases)and the control group(99 cases)by random number table method.On the basis of conventional treatment,the control group was treated with recombinant human interferonα1b for injection,and the observation group was treated with methylprednisolone sodium succinate for injection on the basis of the control group.The treatment course of the two groups was 5 days.The clinical efficacy,disappearance time of clinical symptoms,length of hospital stay,cardiopulmonary function indexes(CK,CK-MB,HR,LVEF,CO,PaO_(2),PaCO_(2)),inflammatory indexes(CRP,TNF-α,NF-κB,IL-6,IL-10)before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(86.73%vs.75.76%,χ^(2)=3.89,P=0.049).The defervescence time,oral herpes disappearance time and length of hospital stay in the observation group were shorter than those in the control group(P<0.01),but there was no significant difference in the disappearance time of skin lesions between the two groups(P>0.05).After 5 days of treatment,there was no statistically significant difference in CO in the control group compared with that before treatment,and the CK,CK-MB,HR,LVEF,PaO_(2)and PaCO_(2)in the two groups were significantly improved before treatment,and the improvement degree in the observation group was greater than that in the control group(P<0.01).The levels of CRP,NF-κB,TNF-α,IL-6 and IL-10 in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05 or P<0.01).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(37.76%vs.25.25%,χ^(2)=3.569,P=0.059).Conclusion Methylprednisolone sodium succinate combined with recombinant human interferonα1b has a definite efficacy in the treatment of severe hand,foot and mouth disease in infants,and can effectively improve the clinical symptoms and cardiopulmonary function of infants,reduce inflammation,and have high safety.
作者
童兵
向梅
周仕海
TONG Bing;XIANG Mei;ZHOU Shihai(Guihang Guiyang Hospital,Guizhou Province,Guiyang 550001,China)
出处
《临床合理用药》
2025年第15期26-30,共5页
Chinese Journal of Clinical Rational Drug Use
基金
2024年贵州省卫生健康科研基金(2024GZWJKJXM0444)。
关键词
重症手足口病
婴幼儿
甲泼尼龙琥珀酸钠
重组人干扰素Α1B
心肺功能
炎性指标
不良反应
Severe hand,foot and mouth disease
Infants
Methylprednisolone sodium succinate
Recombinant human interferonα1b
Cardiopulmonary function
Inflammatory indicators
Adverse reaction
