【摘要】 目的探讨炎性细胞因子与心肌酶在经热毒宁联合丙种球蛋白治疗的手足口病(HFMD)患者血清中的变化。方法选择2013年9月至2017年6月在唐山市丰润区人民医院儿科住院诊治的HFMD患儿120例作为研究对象,根据入院顺序,依照随机信封抽签原则均分为2组,即观察组与对照组,每组60例。对照组给予丙种球蛋白治疗,观察组在对照组治疗的基础上给予热毒宁治疗,2组均治疗观察5 d。结果观察组与对照组的总有效率分别为98.3%和86.7%,观察组优于对照组,差异均有统计学意义(P<0.05)。治疗后观察组的血清EV71或CA16抗体转阴比例分别为92.7%和100.0%,均明显高于对照组的75.0%和50.0%,差异均有统计学意义(P<0.05)。观察组与对照组治疗后的血清白细胞介素-6(IL-6)和C反应蛋白(C-reactive protein, CRP)与治疗前相比明显降低(P<0.05),观察组治疗后的血清IL-6和CRP与对照组相比明显降低,差异均有统计学意义(P<0.05)。治疗后2组的血清肌酸激酶(CK)与心肌型肌酸激酶同功酶(CK-MB)明显低于治疗前,治疗后观察组的血清CK、CK-MB与对照组相比更加降低,差异均有统计学意义(P<0.05)。结论热毒宁联合丙种球蛋白治疗HFMD患儿能抑制血清炎性细胞因子的表达,降低心肌酶的表达,促进病原体转阴,从而提高治疗效果。更多还原

【Abstract】 Objective To investigate changes of serum inflammatory cytokines and myocardial enzymes in the treatment of patients with hand-foot-mouth disease(HFMD) by reduning combined with gamma globulin.Methods One hundred and twenty child patients who were admitted into the Department of Pediatrics of the hospital from September 2013 to June 2017 were recruited as research subjects. In accordance with the sequence of admission, they were divided into the observation group and the control group, each consisting of 60 patients. The control group received intravenous immunoglobulin therapy, while the observation group was given Reduning combined with gamma globulin, in addition to the treatment received by the control group. The 2 groups were all treated and observed for 5 days.Results The total effective rates of the observation group and the control group were respectively 98.3% and 86.7%, with that of the observation group being superior to that of the control group. Statistical significance could be found when comparisons were made between them(P<0.05). After treatment, the negative conversion rates of serum EV71 or CA16 antibody in the observation group were respectively 92.7% and 100%, which were significantly higher than those of 75% and 50% in the control group. Statistical significance could also be found when comparisons were made between them(P<0.05). The levels of serum IL-6 and C-reactive protein(CRP) in the observation group and the control group after treatment were significantly decreased, as compared with those before treatment(P<0.05). The levels of serum IL-6 and CRP in the observation group after treatment were also significantly decreased, as compared with those of the control group. Statistical significance could also be seen when comparisons were made between them(P<0.05). After treatment, the serum levels of CK and CK-MB in the 2 groups were significantly lower than those before treatment(P<0.05), and the serum CK and CK-MB in the observation group after treatment decreased more significantly as compared with those in the control group, also with statistical significance(P<0.05).Conclusion Reduning combined with gamma globulin in treatment of patients with HFMD could inhibit the expressions of serum inflammatory cytokines and myocardial enzymes, promote pathogenic negative conversion, thus enhancing treatment efficacy.更多还原