丙种球蛋白联合α1b干扰素治疗儿童EB病毒感染的疗效分析
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摘要
目的探讨丙种球蛋白联合α1b干扰素治疗儿童EB病毒感染的效果。方法选择佛山市南海区妇幼保健院2015年1月—2018年12月收治的80例EB病毒感染患儿,根据随机数字表法,将所有患儿分为观察组(45例)及对照组(45例),两组患儿均给予抗感染、补液等对症治疗,对照组在对症治疗基础上给予α1b干扰素,观察组在对照组基础上加用丙种球蛋白。对比两组患儿的治疗效果、临床症状改善时间、EB-DNA转阴率、患儿治疗前后的T淋巴细胞亚群水平及治疗过程中不良反应。结果观察组的总有效率为97.8%,对照组为82.2%,观察组的总有效率显著高于对照组(P<0.05)。观察组的体温下降时间、淋巴结消退时间、咽部体征消失时间、异型淋巴细胞恢复正常时间均显著低于对照组(P<0.05)。治疗后,两组患儿的CD4~+、CD4~+/CD8~+显著上升,CD8~+显著下降(P<0.05);且观察组改变幅度显著优于对照组(P<0.05);观察组的EB-DNA转阴率显著高于对照组(P<0.05)。两组治疗过程中不良反应发生情况无统计学差异。结论与单独应用α1b干扰素相比,丙种球蛋白联合α1b干扰素治疗儿童EB病毒感染安全有效,可缩短患儿临床症状改善时间,提高转阴率及患儿免疫功能。
Objective To investigate the efficacy of α1b interferon combined with gamma globulin in treatment of children with EB virus infection. Methods 80 cases with EB virus infection from Jan. 2015 to Dec. 2018 in our hospital were chosen, who were divided to the observation group(45 cases) and control group(45 cases) according to random number table method. The children in two groups were given anti-infection, fluid and other symptomatic treatment, the control group were given atomized inhalation of alpha 1 b interferon on the base of symptomatic treatment, the treatment effect, clinical symptom improvement time, EB-DNA conversion rate, T lymphocyte subsets and adverse reactions before and after treatment in two groups were compared. Results The total efficacy of observation group was higher than control group, the hypothermia time, lymph node regression time, pharyngeal signs disappearance time, and abnormal lymphocyte recovery time were all significantly lower than control group, the CD4~+、CD4~+/CD8~+ of two groups were obvious higher, the CD8~+ were obvious lower, and the changes of observation group were significantly higher than that of control group, the EB-DNA overcast rate of observation group was higher than control group, the adverse reaction of two groups had no significant difference. Conclusion Compared with α1b interferon interferon alone, α1b interferon combined with gamma globulin was safe and effective in treatment of EB virus infection in children, which could shorten the clinical symptoms improvement time, improve the rate of negative conversion and immune function of children.
Objective To investigate the efficacy of α1b interferon combined with gamma globulin in treatment of children with EB virus infection. Methods 80 cases with EB virus infection from Jan. 2015 to Dec. 2018 in our hospital were chosen, who were divided to the observation group(45 cases) and control group(45 cases) according to random number table method. The children in two groups were given anti-infection, fluid and other symptomatic treatment, the control group were given atomized inhalation of alpha 1 b interferon on the base of symptomatic treatment, the treatment effect, clinical symptom improvement time, EB-DNA conversion rate, T lymphocyte subsets and adverse reactions before and after treatment in two groups were compared. Results The total efficacy of observation group was higher than control group, the hypothermia time, lymph node regression time, pharyngeal signs disappearance time, and abnormal lymphocyte recovery time were all significantly lower than control group, the CD4~+、CD4~+/CD8~+ of two groups were obvious higher, the CD8~+ were obvious lower, and the changes of observation group were significantly higher than that of control group, the EB-DNA overcast rate of observation group was higher than control group, the adverse reaction of two groups had no significant difference. Conclusion Compared with α1b interferon interferon alone, α1b interferon combined with gamma globulin was safe and effective in treatment of EB virus infection in children, which could shorten the clinical symptoms improvement time, improve the rate of negative conversion and immune function of children.
引文
[1]单鸣凤,胡静,穆原,等.更昔洛韦联合干扰素-α1b雾化吸入治疗儿童传染性单核细胞增多症的疗效[J].中华实用儿科临床杂志, 2017, 32(15):1174.
[2]崔强华,孙莉,吴琳.干扰素α-1b对传染性单核细胞增多症患儿EB病毒复制及免疫功能的影响[J].儿科药学杂志, 2017, 23(11):20-22.
[3]孙明姝,韩丽,张云清,等.系统性红斑狼疮患者EB病毒感染状态与Ⅰ型干扰素及干扰素诱导基因的相关性研究[J].中华风湿病学杂志, 2016, 20(8):526-531.
[4]王军红.静脉注射丙种球蛋白联合更昔洛韦治疗EB病毒感染疗效观察[J].中国现代药物应用, 2015, 9(14):143-144.
[5]肖楠阳,陈骐,蔡少丽,等. Epstein-Barr病毒的免疫调控与逃逸机制[J].微生物学报, 2016, 56(1):19-25.
[6]许健,吴蓉,相芬芬,等. EB病毒再激活过程中HLA优势基因型的分析[J].检验医学, 2017, 32(6):535-539.
[7]刘元香,徐子刚. EB病毒感染相关皮肤疾病的研究进展[J].中华实用儿科临床杂志, 2016, 31(22):1757-1760.
[8]杨辅直,李伟生,张倩,等.小儿EB病毒感染的临床治疗分析[J].中华医院感染学杂志, 2016, 26(24):5707-5709.
[9]赵继红,王晓光,玄海莲.单磷酸阿糖腺苷治疗小儿EB病毒感染的临床疗效观察[J].中国妇幼保健, 2017, 32(11):2392-2394.
[10]祁建平,祁晓媛,王小娟,等.清温饮联合更昔洛韦治疗小儿EB病毒感染的临床效果及对免疫功能的影响[J].河北医科大学学报, 2017, 38(1):38-42.
[11]宋京霞,张艳.α干扰素联合丙种球蛋白注射液治疗小儿特发性血小板减少性紫癜的疗效观察[J].中国医药指南, 2013, 11(24):609-610.
[12]高颂轶,党清华,高小倩,等.更昔洛韦分别联合神经节苷脂和丙种球蛋白治疗小儿病毒性脑炎的临床疗效研究[J].药物评价研究, 2017, 39(3):373-376.
[13]温荣华.联用α-2b干扰素和丙种球蛋白治疗新生儿病毒性肺炎的疗效探讨[J].当代医药论丛, 2017, 15(15):156-157.
[14]相彩霞,唐云芳,黄新园,等.α-干扰素联合丙种球蛋白治疗儿童传染性单核细胞增多症的疗效观察[J].中国医师进修杂志, 2013, 36(10):67-69.
[15]林燕.丙种球蛋白联合干扰素-α、阿昔洛韦治疗带状疱疹的临床观察[J].临床合理用药杂志, 2009, 2(18):27-28.
[2]崔强华,孙莉,吴琳.干扰素α-1b对传染性单核细胞增多症患儿EB病毒复制及免疫功能的影响[J].儿科药学杂志, 2017, 23(11):20-22.
[3]孙明姝,韩丽,张云清,等.系统性红斑狼疮患者EB病毒感染状态与Ⅰ型干扰素及干扰素诱导基因的相关性研究[J].中华风湿病学杂志, 2016, 20(8):526-531.
[4]王军红.静脉注射丙种球蛋白联合更昔洛韦治疗EB病毒感染疗效观察[J].中国现代药物应用, 2015, 9(14):143-144.
[5]肖楠阳,陈骐,蔡少丽,等. Epstein-Barr病毒的免疫调控与逃逸机制[J].微生物学报, 2016, 56(1):19-25.
[6]许健,吴蓉,相芬芬,等. EB病毒再激活过程中HLA优势基因型的分析[J].检验医学, 2017, 32(6):535-539.
[7]刘元香,徐子刚. EB病毒感染相关皮肤疾病的研究进展[J].中华实用儿科临床杂志, 2016, 31(22):1757-1760.
[8]杨辅直,李伟生,张倩,等.小儿EB病毒感染的临床治疗分析[J].中华医院感染学杂志, 2016, 26(24):5707-5709.
[9]赵继红,王晓光,玄海莲.单磷酸阿糖腺苷治疗小儿EB病毒感染的临床疗效观察[J].中国妇幼保健, 2017, 32(11):2392-2394.
[10]祁建平,祁晓媛,王小娟,等.清温饮联合更昔洛韦治疗小儿EB病毒感染的临床效果及对免疫功能的影响[J].河北医科大学学报, 2017, 38(1):38-42.
[11]宋京霞,张艳.α干扰素联合丙种球蛋白注射液治疗小儿特发性血小板减少性紫癜的疗效观察[J].中国医药指南, 2013, 11(24):609-610.
[12]高颂轶,党清华,高小倩,等.更昔洛韦分别联合神经节苷脂和丙种球蛋白治疗小儿病毒性脑炎的临床疗效研究[J].药物评价研究, 2017, 39(3):373-376.
[13]温荣华.联用α-2b干扰素和丙种球蛋白治疗新生儿病毒性肺炎的疗效探讨[J].当代医药论丛, 2017, 15(15):156-157.
[14]相彩霞,唐云芳,黄新园,等.α-干扰素联合丙种球蛋白治疗儿童传染性单核细胞增多症的疗效观察[J].中国医师进修杂志, 2013, 36(10):67-69.
[15]林燕.丙种球蛋白联合干扰素-α、阿昔洛韦治疗带状疱疹的临床观察[J].临床合理用药杂志, 2009, 2(18):27-28.