不同劑量丙種球蛋白治療重癥手足口病患兒的療效分析

[摘要] 目的 探討不同劑量的丙種球蛋白治療重癥手足口病患兒的療效。 方法 選取2009年3月～2013年3月來院就診的重癥手足口病患兒97例，分為3組。在基礎治療的基礎上，A組給予IVIG 0.2 g/（kg·d）治療；B組予IVIG 1g/（kg·d）治療。C組予羚羊角粉治療。結果 A、B兩組患者NSS好轉、發熱緩解、臨床治愈時間比較，差異均無統計學意義（P>0.05）。A、B兩組與C組比較，NSS好轉、發熱緩解、臨床治愈時間比較，差異均有統計學意義（P<0.05）。A、B兩組治療10 d后復查腦脊液及心電圖正常和異常率比較，差異均無統計學意義（P>0.05）。 結論 及早使用IVIG對手足口病患兒療效顯著；使用大、小劑量IVIG治療重癥手足口病療效相近。

[關鍵詞]丙種球蛋白；重癥手足口病；療效

[中圖分類號] R729 [文獻標識碼] B [文章編號] 2095-0616（2013）13-71-02

Analysis of different dose of gamma globulin in treatment of severe HFMD effect

YU Huajuan1 LIANG Yinzhi2

1.Department of Pediatrics，Long'an County People's Hospital，Long'an 532700，China；2.Department of Preventive Care， Long'an County People's Hospital， Long'an 532700，China

[Abstract] Objective To study the curative effect of children with different dose of gamma globulin in the treatment of severe hand-foot-mouth disease. Methods 97 cases in the hospital with severe hand foot and mouth disease in，from 2009 March to 2013 March were divided into 3 groups.On the basis of conventional treatment， A group was given IVIG 0.2g/（kg .d） treatment；group B was treated with IVIG 1g/（kg .d） treatment.C group was treated with antelope horn powder. Results NSS improving， fever，alleviate clinical cure time comparison between A and Bgroup，the difference was not statistically significant（P>0.05）.But NSS improved，fever，alleviate clinical cure time comparison among A，B two group and C group，the differences were statistically significant（P<0.05）.A， B two groups after 10 d treatment cerebrospinal fluid and normal ECG and abnormal rate， the difference is not statistically significant（P>0.05）. Conclusion Early use of IVIG significantly in children with hand-foot-and-mouth disease curative has effect；The use of large， small doses of IVIG had similar effect in treatment of severe hand-foot-mouth disease.

[Key words] Gamma globulin；Hand-foot-and-mouth disease；Curative effect

手足口病（Hand-foot-mouth Disease，HFMD）是由多種腸道病毒引發的急性的傳染病，主要臨床特征為發熱、口腔疼痛性水皰以及手足皰疹，是一種比較常見的兒科傳染病。本病傳染性強，傳播快，短時間可造成大流行[1]。本研究選取2009年3月～2013年3月來院就診的重癥手足口病患兒87例，采用不同劑量的丙種球蛋白（IVIG）治療，報道如下。

1 資料與方法

1.1 一般資料

選取2009年3月～2013年3月來院就診的重癥手足口病患兒87例，所有患兒皆符合我《手足口病診療指南（2010年版）》中的重癥手足口病病例標準。男52例，女35例，年齡3個月～12歲，平均（3.1±1.6）歲。所有患兒按照隨機數字表法分為A組（低劑量組）28例和B組（大劑量組）29例。均經倫理委員會批準，且患兒家屬知情同意。A組患兒，男17例，女11例；年齡3個月～11歲，平均（3.00±1.53）歲。B組患兒，男16例，女13例；年齡4個月～12歲，平均（3.12±1.52）歲。C組患兒30例，男17例，女13例；……