目的 分析丙种球蛋白联合重组人干扰素α1b治疗小儿病毒性脑炎（viral encephaliti,VE）疗效及对血清C-反应蛋白（C-reactive protein,CRP）、白细胞介素6（interleukin-6,IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）水平的影响。方法 回顾性收集2022年1月—2023年12月98例VE患儿临床资料,根据治疗方法不同分为干扰素组（51例）及联合组（47例）,干扰素组给予抗病毒、降颅压等常规治疗及重组人干扰素α1b治疗,联合组在干扰素组基础上联合丙种球蛋白治疗。记录2组患儿临床症状、体征消失时间,比较2组患儿治疗前及治疗5d后免疫功能T淋巴细胞亚群（CD4+、CD8+、CD4+/CD8+）、免疫球蛋白[IgE、IgG]、炎症因子（CRP、IL-6、TNF-α）、脑损伤相关因子[Tau蛋白、神经生长因子（nerve growth factor,NGF）、神经元特异性烯醇化酶（neuron-specific enolase,NSE）],并评估用药安全性。结果 联合组的退热时间、头痛消失时间、头晕消失时间、呕吐消失时间、抽搐消失时间和脑膜刺激征消失时间均短于干扰素组。治疗5 d后,联合组的CD4+、CD4+/CD8+、IgE、IgG的水平更高,血清CRP、IL-6、TNF-α、血清Tau蛋白、NGF、NSE的水平更低。两组药物不良反应发生率比较,无显著差异。结论 丙种球蛋白联合重组人干扰素α1b治疗儿童VE,能改善患儿免疫功能,减轻炎症反应及脑损伤,促临床症状、体征缓解,安全性良好。
Abstract
Objective To analyze the efficacy of gamma globulin combined with recombinant human interferon α1b in the treatment of viral encephalitis (VE) in children and its influence on serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels. Methods The clinical data of 98 children with VE from January 2022 to December 2023 were retrospectively collected. According to different treatment methods, they were divided into interferon group (51 cases) and combined group (47 cases). The interferon group was given conventional treatments such as antiviral therapy and intracranial pressure reduction and recombinant human interferon α1b treatment, while the combined group was combined with gamma globulin on the basis of the interferon group. The disappearance times of clinical symptoms and signs in the two groups were recorded. The immune function T lymphocyte subsets (CD4+, CD8+, CD4+/CD8+), immunoglobulin[IgE, IgG], inflammatory factors (CRP, IL-6, TNF-α), and brain injury-related factors [Tau protein, nerve growth factor (NGF), neuron-specific enolase (NSE)] were compared between the two groups before treatment and after 5 days of treatment, and the safety of medication was evaluated. Results The time to defervescence, disappearance of headache, dizziness, vomiting, seizures, and meningeal irritation signs in the combined group was shorter than that in the interferon group. After 5 days of treatment, the levels of CD4+, CD4+/CD8+ ratio, IgE, and IgG in the combined group were higher than those in the interferon group, while the serum levels of CRP, IL-6, TNF-α, Tau protein, NGF, and NSE were lower than those in the interferon group, and the differences were statistically significant. There was no significant difference in the incidence of adverse drug reactions between the two groups. Conclusion Gamma globulin combined with recombinant human interferon α1b in the treatment of VE in children can improve the immune function, relieve the inflammatory response and brain injury, and promote the reliefs of clinical symptoms and signs, and it has good safety.
关键词
病毒性脑炎 /
儿童 /
丙种球蛋白 /
重组人干扰素α1b /
免疫功能 /
炎症
Key words
viral encephalitis /
children /
gamma globulin /
recombinant human interferon α1b /
immune function /
inflammation
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基金
山西省基础研究计划项目“追赶生长对宫内发育迟缓大鼠胰岛功能的影响及机制研究”（202403021211167）
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