钟秀华+陈普拉+慕容三群+邓俊能+谭锦光

[摘要] 目的 探讨早期静脉注射人免疫球蛋白治疗重症手足口病的临床效果。 方法 将62例重症手足口病患儿分为治疗组（n=31）和对照组（n=31），给予抗炎、抗病毒、退热等常规治疗，治疗组在常规治疗的基础上早期静脉注射人免疫球蛋白，观察两组的临床疗效及精神症状改善、体温消退、食欲改善情况及平均住院时间。 结果 治疗组显效率及总有效率明显高于对照组（P＜0.05）；治疗组的体温消退时间、食欲改善时间、精神症状消失时间、平均住院时间明显短于对照组，两组差异有统计学意义（P＜0.05）。 结论 早期静脉注射人免疫球蛋白能明显改善重症手足口病患儿的症状，临床疗效显著，且通过早期积极干预可缩短病程、减轻症状、缩短住院时间。

[关键词] 手足口病；免疫球蛋白；退热

[中图分类号] R725.1[文献标识码] A[文章编号] 1674-4721（2014）03（c）-0064-02

Clinical research of early intravenous human immunoglobulin in treatment of severe hand,foot and mouth disease

ZHONG Xiu-hua CHEN Pu-la MURONG San-qun DENG Jun-neng TAN Jin-guang

People′s Hospital of Gaoyao City in Guangdong Province,Gaoyao 526040,China

[Abstract] Objective To explore the clinical curative effect of early intravenous injection human immunoglobulin in treatment of severe hand foot mouth disease. Methods 62 cases of patients with severe hand foot mouth disease were divided into treatment group (n=31) and control group (n=31),all were given with anti-inflammatory,antiviral,antipyretic and other conventional treatment,the treatment group patients were given early intravenous immunoglobulin therapy on the basis of conventional,and the clinical curative effect of two groups and mental symptoms,fever subsided,the appetite to improve the situation and the average length of stay were observed. Results The markedly effective rate and total effective rate of the treatment group was significantly higher than that of the control group respectively (P<0.05).The time of body temperature,appetite improved time,psychiatric symptom disappearance time,the average hospitalization time of the treatment group was shorter than that of the control group respectively,the two groups had significant difference (P<0.05). Conclusion Early human immunoglobulin for intravenous injection can obviously improve the symptoms of children with severe hand foot and mouth disease, the clinical curative effect is remarkable,and by early active intervention can shorten the course,reduce symptoms,shorten the hospitalization days.

[Key words] Hand foot and mouth disease;Immunoglobulin;Subsided fever

手足口病是一种由肠道病毒引起的急性传染病，该病传染性强、传播途径复杂、流行强度大、病情进展迅速，常见于婴幼儿及学龄儿童，个别患儿可并发无菌性脑膜脑炎、脑脊髓炎、脑干脑炎等中枢神经系统疾病及心肌炎、肺水肿等严重并发症，甚至死亡，严重威胁患儿的健康[1]。近年来研究表明，早期静脉应用丙种免疫球蛋白可补充含有广谱抗病毒、细菌和其他病原体的IgG抗体，封闭抗原，早期阻断病毒在体内复制，增强免疫力，还可刺激机体产生相应的抗病毒抗体，阻止重症手足口病患儿的病情进展，明显改善症状、缩短病程，对重症手足口病患儿的治疗具有重要意义[2]。……