目的 探究甲基潑尼松龍聯(lián)合人免疫球蛋白對于急性播散性腦脊髓患兒免疫功能的改善情況及臨床療效。方法 選取2017年1月-2017年12月至株洲市中心醫(yī)院治療的急性播散性腦脊髓炎患兒98例，按隨機數(shù)字表法分為甲基潑尼松龍組和地塞米松組，每組均49例，兩組患者均予以人免疫球蛋白400~500 mg/（kg· d），治療3~5 d。甲基潑尼松龍組患者予以注射用甲潑尼龍琥珀酸鈉10~15 mg/（kg· d），地塞米松組患者予以地塞米松0.5 mg/（kg· d）。兩組均治療1個月。另選取至株洲市中心醫(yī)院體檢的健康患兒49例作為對照組，采用免疫比濁法檢測3組免疫球蛋白IgA、IgG、IgE、IgM，記錄比較接受治療的兩組患兒癥狀消失時間、療效及不良反應發(fā)生情況。結果 治療前，與對照組比較，兩組患兒IgG和IgM顯著升高，差異有統(tǒng)計學意義（P<0.05）；而兩組患兒組間比較差異均無統(tǒng)計學意義。治療后，兩組患兒IgG和IgM水平均有下降，與治療前相比差異均有統(tǒng)計學意義（P<0.05）；且甲基潑尼松龍組各項指標均恢復到正常水平，與對照組比較差異均無統(tǒng)計學意義；而地塞米松組IgG和IgM水平高于對照組和甲基潑尼松龍組，差異有統(tǒng)計學意義（P<0.05）。甲基潑尼松龍組癥狀緩解時間短于地塞米松組，差異有統(tǒng)計學意義（P<0.05）。甲基潑尼松龍組治療有效率為97.96%，高于地塞米松組的87.76%，差異有統(tǒng)計學意義（χ²=6.091，P<0.05）。治療期間兩組患兒均未出現(xiàn)嚴重不良反應，甲基潑尼松龍組不良反應發(fā)生率為20.41%，地塞米松組為26.83%，兩組差異無統(tǒng)計學意義。結論 甲基潑尼松龍可明顯改善急性播散性腦脊髓炎患兒的免疫功能，臨床療效好且不良反應較少，值得臨床推廣使用。

Objective To investigate the effect of methylprednisolone on immune function and clinical efficacy in children with acute disseminated cerebral spinal cord.Methods 98 children with acute disseminated encephalomyelitis treated in our hospital from January 2017 to December 2017 were selected and divided into methylation prednisone group and dexamethasone group by random number table method.49 patients in each group.49 healthy children who had physical examination in our hospital were selected as the control group.Immunoglobulin assay was used to detect three groups of IgA,IgG,IgE,and IgM.The symptom remission time,efficacy,and adverse reactions of the two groups were recorded.Results There was no significant difference in IgA and IgE between the two groups of children with acute disseminated cerebral spinal cord and the control group,IgG and IgM were higher than the control group,the difference was statistically significant (P<0.05).After treatment,the levels of IgG and IgM decreased in the two groups,and the decrease in the methylprednisolone group was more obvious.The difference was statistically significant (P<0.05).The symptom remission time of methylprednisolone group was less than dexamethasone group,the difference was statistically significant (P<0.05).The effective rate of methylprednisolone group was 97.96%,higher than that of the dexamethasone group,the diffidence was statistically significant (χ²=6.091,P<0.05).No serious adverse reactions occurred during the treatment period in both groups.The prevalence of methylprednisolone was 20.41%,and that of dexamethasone was 26.83%,there was no significant difference between the two groups.Conclusion Methylprednisolone can significantly improve the immune function of children with acute disseminated encephalomyelitis,with good clinical efficacy and fewer adverse reactions.It is worthy of clinical application.