目的 探討免疫球蛋白聯(lián)合匹多莫德和利巴韋林治療兒童重癥手足口病的臨床療效。方法 選取2013年1月-2015年1月秦皇島市第三醫(yī)院收治的重癥手足口病患兒100例,隨機分成對照組和治療組,每組50例,對照組患兒靜脈滴注利巴韋林注射液,10mg/kg,1次/d;口服匹多莫德口服液400mg/次,1次/d。治療組在對照組的基礎(chǔ)上,靜脈滴注靜注人免疫球蛋白(pH4),1.5mL/kg,1次/d。兩組均連續(xù)治療7d。觀察兩組的臨床效果,比較患兒發(fā)熱消退、口腔潰瘍消退、皮疹消退及痊愈時間,同時比較血清肌酸激酶(CK)和C反應(yīng)蛋白(CRP)水平的變化。結(jié)果 治療后,對照組和治療組的總有效率分別為80.00%、100.00%,差異有統(tǒng)計學(xué)意義(P<0.01);治療組患兒的發(fā)熱消退時間、口腔潰瘍消退時間、皮疹消退時間、痊愈時間均顯著短于對照組患兒,兩組比較差異有統(tǒng)計學(xué)意義(P<0.01)。治療后,兩組患兒CK和CRP均明顯降低,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.01)。結(jié)論 免疫球蛋白聯(lián)合匹多莫德和利巴韋林治療兒童重癥手足口病具有良好的臨床療效,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the curative effect of immunoglobulin combined with pidotimod and ribavirin in treatment of children with severe hand-foot-mouth disease. Methods Children (100 cases) with severe hand-foot-mouth disease in Qinhuangdao Third Hospital from January 2013 to January 2015 were enrolled in this study. According to different treatment plans the patients were divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were iv administered with Ribavirin Injection, 10 mg/kg, once daily, and were po administered with Pidotimod Oral Solution, 400 mg/time, once daily. Patients in the treatment group were iv administered with Human Immunoglobulin (pH4) for iv injection on the basis of control group, 1.5 mL/kg, once daily. The patients in two groups were treated for 7 d. The clinical efficacy in two groups was evaluated, the subsided time of fever, oral ulcer, skin rash, recovery time, changes of CK and CRP levels were compared in two groups before and after treatment. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 100.00%, respectively, and there were differences between two groups (P < 0.01). After treatment, the subsided time of fever, oral ulcer, skin rash, and recovery time in treatment group were lower than those in the control group, the difference was statistically significant (P < 0.01). The CK and CRP levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). difference was statistically significant in the same group (P < 0.01), and there was no difference between two groups. Conclusion Immunoglobulin combined with pidotimod and ribavirin in treatment of children with severe hand-foot-mouth disease has good curative effect, which has a certain clinical application value.