干扰素联合利巴韦林气雾剂治疗手足口病患儿的疗效及对免疫功能的影响
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摘要
目的:探讨干扰素联合利巴韦林气雾剂治疗手足口病患儿的疗效以及对T淋巴细胞亚群及Th1、Th2细胞水平的影响,以期为临床治疗提供参考。方法:选取我院2016年10月至2017年10月收治的120例手足口病患儿作为研究对象,按随机数字表法分为观察组和对照组各60例,所有患儿均予以常规对症支持治疗,对照组在此基础上加用利巴韦林气雾剂,观察组在对照组治疗基础上加用干扰素,评价治疗后病毒转阴率、临床有效率、对淋巴细胞亚群及Th1、Th2型细胞水平的影响以及安全性。结果:观察组的病毒转阴率为74. 14%,显著高于对照组的43. 10%,差异有统计学意义(P <0. 05);观察组临床有效率为95. 00%,显著高于对照组的80. 00%(P<0. 05);治疗5 d后,两组患儿的CD4~+细胞水平以及CD4~+/CD8~+均有不同程度升高,且观察组均显著高于对照组(P<0. 05);治疗后观察组Th1细胞水平高于对照组(P<0. 05),Th2细胞水平低于对照组,差异有统计学意义(P<0. 05);观察组Th1/Th2值高于对照组,差异有统计学意义(P<0. 05)。结论:干扰素联合利巴韦林气雾剂治疗手足口病患儿可有效提高病毒转阴率,改善患儿的免疫失衡状态,临床疗效较好,具有较大的应用价值。
Objective: To probe into the efficacy of interferon combined with ribavirin aerosol in the treatment of children with hand,foot and mouth disease and its effects on lymphocyte subsets and Th1 and Th2 cell levels,so as to provide reference for clinical treatment.Methods: Totally 120 children with hand,foot and mouth disease admitted into our hospital from Oct.2016 to Oct.2017 were extracted to be divided into the observation group and the control group via the random number table,with 60 cases in each group.All children were given conventional symptomatic support treatment,the control group was treated with ribavirin aerosol on this basis,and the observation group received interferon on the basis of the control group. The effect and safety of virus conversion rate,clinical efficiency,lymphocyte subsets and Th1,Th2 type cell levels were evaluated after treatment. Results: The virus conversion rate of the observation group was 74. 14%,significantly higher than that of the control group( 43. 10%),and the difference was statistically significant( P<0. 05).The clinical effective rate of the observation group was 95. 00%,significantly higher than that of the control group( 80. 00%,P<0. 05).After treatment of 5 d,CD4~+cells and CD4~+/CD8~+in both groups were increased to different degree,and the observation group was significantly higher than the control group( P<0. 05).After treatment,the Th1 cells in the observation group were higher than the control group( P<0. 05),and the Th2 cells were lower than the control group,the difference was statistically significant( P<0. 05).The Th1/Th2 value in the observation group was higher than that in the control group,and the difference was statistically significant( P<0. 05). Conclusion: Interferon combined with ribavirin aerosol in the treatment of children with hand,foot and mouth disease can effectively improve the rate of viral conversion,improve the immune imbalance of children,with better clinical efficacy and greater value.
Objective: To probe into the efficacy of interferon combined with ribavirin aerosol in the treatment of children with hand,foot and mouth disease and its effects on lymphocyte subsets and Th1 and Th2 cell levels,so as to provide reference for clinical treatment.Methods: Totally 120 children with hand,foot and mouth disease admitted into our hospital from Oct.2016 to Oct.2017 were extracted to be divided into the observation group and the control group via the random number table,with 60 cases in each group.All children were given conventional symptomatic support treatment,the control group was treated with ribavirin aerosol on this basis,and the observation group received interferon on the basis of the control group. The effect and safety of virus conversion rate,clinical efficiency,lymphocyte subsets and Th1,Th2 type cell levels were evaluated after treatment. Results: The virus conversion rate of the observation group was 74. 14%,significantly higher than that of the control group( 43. 10%),and the difference was statistically significant( P<0. 05).The clinical effective rate of the observation group was 95. 00%,significantly higher than that of the control group( 80. 00%,P<0. 05).After treatment of 5 d,CD4~+cells and CD4~+/CD8~+in both groups were increased to different degree,and the observation group was significantly higher than the control group( P<0. 05).After treatment,the Th1 cells in the observation group were higher than the control group( P<0. 05),and the Th2 cells were lower than the control group,the difference was statistically significant( P<0. 05).The Th1/Th2 value in the observation group was higher than that in the control group,and the difference was statistically significant( P<0. 05). Conclusion: Interferon combined with ribavirin aerosol in the treatment of children with hand,foot and mouth disease can effectively improve the rate of viral conversion,improve the immune imbalance of children,with better clinical efficacy and greater value.
引文
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[11]王欣,廖明,柴中平,等.重组人干扰素α-1b注射液雾化吸入辅助治疗手足口病疗效和安全性的系统评价[J].儿科药学杂志,2018,24(10):5-9.
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[14]邓慧玲,张玉凤,符佳,等.手足口病患儿机体免疫功能变化及细胞因子水平的相关研究[J].医学临床研究,2015,32(2):209-211.
[15]王跃飞,林邦长,何哲航,等.T淋巴细胞亚群与调节性B细胞在儿童手足口病中的表达及临床意义[J].中华医院感染学杂志,2017,27(14):3319-3322.
[16]杜潘艳,赵丽梅,乔国昱,等.手足口病患儿淋巴细胞亚群及Th1/Th2型细胞因子表达[J].中国热带医学,2015,15(1):22-24.
[17]LIN H,HUANG L,ZHOU J,et al.Efficacy and safety of interferon-α2b spray in the treatment of hand,foot,and mouth disease:A multicenter,randomized,double-blind trial[J].Archives of virology,2016,161(11):1-8.
[2]WANG P,GOGGINS W B,CHAN E Y Y.Hand,foot and mouth disease in Hong Kong:A time-series analysis on its relationship with weather[J].PLoS One,2016,11(8):e0161006.
[3]WANG Z,NICHOLLS J M,LIU F,et al.Pulmonary and central nervous system pathology in fatal cases of hand foot and mouth disease caused by enterovirus 71 infection[J].Pathology,2016,48(3):267.
[4]谭静,王武明,雷克竟.丙种球蛋白静脉滴注联合干扰素雾化吸入治疗儿童重症手足口病疗效观察[J].儿科药学杂志,2017,23(7):21-23.
[5]ZHU L,LI W,QI G,et al.The immune mechanism of intestinal tract Toll-like receptor in mediating EV71 virus type severe handfoot-and-mouth disease and the MAPK pathway[J].Experimental&therapeutic medicine,2017,13(5):2263-2266.
[6]HUANG X,ZHANG X,WANG F,et al.Clinical efficacy of therapy with recombinant human interferonα1b in hand,foot,and mouth disease with enterovirus 71 infection[J].PLoS One,2016,11(2):e0148907.
[7]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志,2010,(24):1473-1475.
[8]李晶滢,杨华升,杨薇,等.中医药治疗手足口病的目标及疗效评价标准探讨[J].时珍国医国药,2013(1):170-171.
[9]LI T,YANG Z,DI B,et al.Hand-foot-and-mouth disease and weather factors in Guangzhou,southern China[J].Epidemiology&infection,2014,142(8):1741-1750.
[10]卢晓红.干扰素与利巴韦林治疗儿童手足口病的疗效及安全性对比观察[J].中国医药指南,2018,16(9):127-128.
[11]王欣,廖明,柴中平,等.重组人干扰素α-1b注射液雾化吸入辅助治疗手足口病疗效和安全性的系统评价[J].儿科药学杂志,2018,24(10):5-9.
[12]FUSTER D,SANVISENS A,BOLAO F,et al.Alcohol use disorder and its impact on chronic hepatitis C virus and human immunodeficiency virus infections[J].World journal of hepatology,2016,8(31):1295-1308.
[13]朱晓华,陈强,李秋根,等.儿童巨细胞病毒感染致喘息发生的免疫学机制[J].中国当代儿科杂志,2016,18(9):831-834.
[14]邓慧玲,张玉凤,符佳,等.手足口病患儿机体免疫功能变化及细胞因子水平的相关研究[J].医学临床研究,2015,32(2):209-211.
[15]王跃飞,林邦长,何哲航,等.T淋巴细胞亚群与调节性B细胞在儿童手足口病中的表达及临床意义[J].中华医院感染学杂志,2017,27(14):3319-3322.
[16]杜潘艳,赵丽梅,乔国昱,等.手足口病患儿淋巴细胞亚群及Th1/Th2型细胞因子表达[J].中国热带医学,2015,15(1):22-24.
[17]LIN H,HUANG L,ZHOU J,et al.Efficacy and safety of interferon-α2b spray in the treatment of hand,foot,and mouth disease:A multicenter,randomized,double-blind trial[J].Archives of virology,2016,161(11):1-8.