早期使用重组人干扰素-α1b雾化治疗手足口病的临床效果及对炎症反应的调控作用研究
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摘要
目的:分析早期使用重组人干扰素-α1b雾化治疗手足口病的临床效果及对炎症反应的调控作用。方法:选取2017年6月-2018年5月在本院诊治的92例手足口病患儿。按照随机数字表法将其分为对照组(常规手足口病治疗)和观察组(常规治疗联合重组人干扰素-α1b雾化治疗),各46例。比较两组临床疗效、症状体征(发热、口腔溃疡及手足皮疹)改善时间及治疗前后的血清炎性细胞因子水平(IL-1β、IL-6、IL-10)。结果:观察组治疗后3、7 d的临床总有效率分别为86.96%、100%,均高于对照组的69.57%、89.13%,比较差异均有统计学意义(P<0.05);观察组发热、口腔溃疡及手足皮疹改善时间均短于对照组,比较差异均有统计学意义(P<0.05);治疗后,观察组IL-1β、IL-6、IL-10水平均低于对照组,比较差异均有统计学意义(P<0.05)。结论:早期使用重组人干扰素-α1b雾化治疗手足口病的临床效果较好,且对炎症反应的调控作用也较为明显,因此适用于手足口病的临床治疗。
Objective:To analyze the clinical effect of early application of Recombinant Human Interferon-α1b by atomization therapy in the patients with hand-foot-and-mouth disease and regulation role for inflammatory response.Method:A total of 92 children with hand-foot-and-mouth disease in our hospital from June 2017 to May 2018 were selected.According to the random number table method,they were divided into control group(routine treatment of hand-foot-and-mouth disease)and observation group(routine treatment combined with Recombinant Human Interferon-α1b by atomization therapy),46 cases in each group.The clinical efficacy,symptoms and signs(fever,oral ulcer and hand-foot rash)improvement time and serum inflammatory cytokine levels(IL-1β,IL-6,IL-10)before and after treatment between two groups were compared.Result:After treatment 3 and 7 days,the clinical total effective rates of observation group were 86.96% and 100% respectively,which were higher than 69.57% and 89.13% of control group,the differences were statistically significant(P<0.05).The improvement time of fever,oral ulcer and hand-foot rash in observation group were shorter than those of control group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-1β,IL-6 and IL-10 in observation group were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of early application of Recombinant Human Interferon-α1b by atomization therapy in the patients with hand-foot-and-mouth disease is better,and its regulation role for inflammatory response is obvious too,so it is suitable to the clinical treatment of hand-foot-and-mouth disease.
Objective:To analyze the clinical effect of early application of Recombinant Human Interferon-α1b by atomization therapy in the patients with hand-foot-and-mouth disease and regulation role for inflammatory response.Method:A total of 92 children with hand-foot-and-mouth disease in our hospital from June 2017 to May 2018 were selected.According to the random number table method,they were divided into control group(routine treatment of hand-foot-and-mouth disease)and observation group(routine treatment combined with Recombinant Human Interferon-α1b by atomization therapy),46 cases in each group.The clinical efficacy,symptoms and signs(fever,oral ulcer and hand-foot rash)improvement time and serum inflammatory cytokine levels(IL-1β,IL-6,IL-10)before and after treatment between two groups were compared.Result:After treatment 3 and 7 days,the clinical total effective rates of observation group were 86.96% and 100% respectively,which were higher than 69.57% and 89.13% of control group,the differences were statistically significant(P<0.05).The improvement time of fever,oral ulcer and hand-foot rash in observation group were shorter than those of control group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-1β,IL-6 and IL-10 in observation group were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of early application of Recombinant Human Interferon-α1b by atomization therapy in the patients with hand-foot-and-mouth disease is better,and its regulation role for inflammatory response is obvious too,so it is suitable to the clinical treatment of hand-foot-and-mouth disease.
引文
[1]刘辉保,符卫民,熬小冬.重组人干扰素α1b不同给药途径在小儿手足口病治疗中的作用研究[J].中国当代医药,2016,23(23):78-80.
[2]张小丹,田亚坤,熊芳,等.重组人干扰素α-2b注射液雾化吸入治疗儿童手足口病的疗效观察[J].现代药物与临床,2014,29(4):404-407.
[3]瞿色华,周瑞.重组人干扰素α2b治疗重型早期手足口病疗效观察[J].中华全科医学,2017,15(12):2053-2055.
[4]袁静,李茜,陶明锐,等.中药和重组人干扰素α-1b预防手足口病效果分析[J].预防医学论坛,2016,22(7):502-504.
[5]朱琳.重组人干扰素α-1b雾化吸入治疗手足口病效果观察[J].常州实用医学,2016,32(3):152-154.
[6]徐艳利,田庆玲,姜太一,等.雾化吸入重组人干扰素α1b对重症手足口病早期的治疗作用[J].中华实用儿科临床杂志,2015,30(8):627-630.
[7]臧亚勤,徐亮,沈耀红.蒲地蓝消炎口服液联合重组人干扰素α1b注射液治疗普通型手足口病的疗效观察[J].现代药物与临床,2016,31(12):1967-1970.
[8]Sabitha S,Sasidharanpillai S,Sanjay R E,et al.Clinical profile and virology analysis of hand,foot and mouth disease cases from North Kerala,India in 2015-2016:A tertiary care hospitalbased cross-sectional study[J].Indian J Dermatol Venereol Leprol,2018,84(3):328-331.
[9]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].Exp Ther Med,2017,13(5):2263-2266.
[10]刘少锋,余杜生.注射用重组人干扰素α-1b雾化联合脾氨肽口服干冻粉治疗小儿手足口病临床观察[J].深圳中西医结合杂志,2017,27(12):110-111.
[11]陈聪,余春梅,王晓宇.重组人干扰素α1b雾化治疗121例手足口病疗效分析[J].检验医学与临床,2014,11(9):1233-1234.
[12]任蕊.重组人干扰素α1b治疗84例小儿手足口病临床效果[J].现代诊断与治疗,2017,28(21):3983-3984.
[13]贾庆岭,申艺坤,杨新利,等.喜炎平联合外用重组人干扰素α-2b喷雾剂治疗小儿手足口病的疗效观察[J].生物医学工程与临床,2016,20(4):407-408,435.
[14]张瑜,谢燕,袁娟,等.雾化吸入IFN-α1b对重症手足口病脑保护作用的研究[J].中国妇幼健康研究,2017,28(9):1071-1074.
[15]Sun J F,Li H L,Sun B X.Correlation analysis on serum inflammatory cytokine level and neurogenic pulmonary edema for children with severe hand-foot-mouth disease[J].Eur J Med Res,2018,23(1):21.
[16]Lee J Y,Son M,Kang J H,et al.Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus71-induced hand,foot and mouth disease[J].Postgrad Med,2018,130(2):258-263.
[17]谢松松,朱庆峰,左维泽.手足口病患儿血清白细胞介素-10、白细胞介素-13和γ干扰素的检测及临床意义[J].中华传染病杂志,2017,35(4):240-241.
[18]王佳.干扰素联合炎唬宁治疗对手足口病患儿血清细胞因子及免疫球蛋白水平的影响[J].医学综述,2016,22(6):1234-1236.
[19]毛其芬,崔大伟,杨先知,等.手足口病患儿细胞因子水平及免疫球蛋白的变化及其临床意义[J].中国微生态学杂志,2017,29(3):305-308.
[20]卢恩敏,胡润伟,高丽京,等.EV71感染的湿热毒盛型手足口病患儿脑脊液Th1、Th2细胞因子变化及临床意义[J].辽宁中医药大学学报,2015,17(9):174-176.
[2]张小丹,田亚坤,熊芳,等.重组人干扰素α-2b注射液雾化吸入治疗儿童手足口病的疗效观察[J].现代药物与临床,2014,29(4):404-407.
[3]瞿色华,周瑞.重组人干扰素α2b治疗重型早期手足口病疗效观察[J].中华全科医学,2017,15(12):2053-2055.
[4]袁静,李茜,陶明锐,等.中药和重组人干扰素α-1b预防手足口病效果分析[J].预防医学论坛,2016,22(7):502-504.
[5]朱琳.重组人干扰素α-1b雾化吸入治疗手足口病效果观察[J].常州实用医学,2016,32(3):152-154.
[6]徐艳利,田庆玲,姜太一,等.雾化吸入重组人干扰素α1b对重症手足口病早期的治疗作用[J].中华实用儿科临床杂志,2015,30(8):627-630.
[7]臧亚勤,徐亮,沈耀红.蒲地蓝消炎口服液联合重组人干扰素α1b注射液治疗普通型手足口病的疗效观察[J].现代药物与临床,2016,31(12):1967-1970.
[8]Sabitha S,Sasidharanpillai S,Sanjay R E,et al.Clinical profile and virology analysis of hand,foot and mouth disease cases from North Kerala,India in 2015-2016:A tertiary care hospitalbased cross-sectional study[J].Indian J Dermatol Venereol Leprol,2018,84(3):328-331.
[9]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].Exp Ther Med,2017,13(5):2263-2266.
[10]刘少锋,余杜生.注射用重组人干扰素α-1b雾化联合脾氨肽口服干冻粉治疗小儿手足口病临床观察[J].深圳中西医结合杂志,2017,27(12):110-111.
[11]陈聪,余春梅,王晓宇.重组人干扰素α1b雾化治疗121例手足口病疗效分析[J].检验医学与临床,2014,11(9):1233-1234.
[12]任蕊.重组人干扰素α1b治疗84例小儿手足口病临床效果[J].现代诊断与治疗,2017,28(21):3983-3984.
[13]贾庆岭,申艺坤,杨新利,等.喜炎平联合外用重组人干扰素α-2b喷雾剂治疗小儿手足口病的疗效观察[J].生物医学工程与临床,2016,20(4):407-408,435.
[14]张瑜,谢燕,袁娟,等.雾化吸入IFN-α1b对重症手足口病脑保护作用的研究[J].中国妇幼健康研究,2017,28(9):1071-1074.
[15]Sun J F,Li H L,Sun B X.Correlation analysis on serum inflammatory cytokine level and neurogenic pulmonary edema for children with severe hand-foot-mouth disease[J].Eur J Med Res,2018,23(1):21.
[16]Lee J Y,Son M,Kang J H,et al.Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus71-induced hand,foot and mouth disease[J].Postgrad Med,2018,130(2):258-263.
[17]谢松松,朱庆峰,左维泽.手足口病患儿血清白细胞介素-10、白细胞介素-13和γ干扰素的检测及临床意义[J].中华传染病杂志,2017,35(4):240-241.
[18]王佳.干扰素联合炎唬宁治疗对手足口病患儿血清细胞因子及免疫球蛋白水平的影响[J].医学综述,2016,22(6):1234-1236.
[19]毛其芬,崔大伟,杨先知,等.手足口病患儿细胞因子水平及免疫球蛋白的变化及其临床意义[J].中国微生态学杂志,2017,29(3):305-308.
[20]卢恩敏,胡润伟,高丽京,等.EV71感染的湿热毒盛型手足口病患儿脑脊液Th1、Th2细胞因子变化及临床意义[J].辽宁中医药大学学报,2015,17(9):174-176.