| 摘要: |
| 目的：探讨利巴韦林与干扰素α1b在小儿手足口病的应用价值。方法：选择2012年5-8月在杭州市儿童医院住院治疗的确诊为手足口病（HFMD）的患儿488例，其中轻症349例，重症139例，分别按治疗用药情况分为干扰素组、利巴韦林组和对照组。对照组仅给予对症治疗，包括补液，静脉滴注能量合剂、维生素C，体温>38.5 ℃时口服布洛芬或用冰袋等物理降温等；干扰素组在对症治疗的基础上，给予干扰素α1b 0.5 μg/（kg·d）肌肉注射，连续5 d；利巴韦林组在对症治疗的基础上，给予利巴韦林10 mg/（kg·d）静脉滴注，连续7 d。比较三组症状体征消退时间及住院时间，评价疗效，并采用流式细胞微球阵列术检测重症患儿脑脊液中各细胞因子水平。结果：同一病情的三组患儿退热时间、皮疹消退时间、口腔溃疡消退时间、住院时间比较差异均无统计学意义（P均>0.05）。同一病情的三组患儿总有效率比较差异均无统计学意义（P均>0.05）。重症三组恢复期脑脊液IL-1β、IL-12p70水平均未见明显下降（P均>0.05）。干扰素组和利巴韦林组恢复期CCL2/MCP-1、CCL5/RANTES、IL-10水平较急性期明显下降（P均<0.05）；但对照组恢复期脑脊液CCL2/MCP-1水平较急性期升高（P<0.05），CCL5/RANTES、IL-10水平未见明显变化（P均>0.05）。结论：在对症治疗的基础上，应用利巴韦林或干扰素对小儿HFMD进行抗病毒治疗的效果不明显，但是否对单核细胞趋化因子-1（MCP-1）有影响，有待进一步研究。 |
| 关键词: 手足口病 小儿 利巴韦林 干扰素α1b 脑脊液 细胞因子 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.06.005 |
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| 基金项目:浙江省医药卫生科技计划项目，项目编号2012KYB159。 |
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| Research of Ribavirin and Interferon α1b in the Treatment of Children with Hand-Foot-Mouth Disease |
| Cai Chunyan, Wang Zhongmin, Zhao Shiyong |
| (Children's Hospital of Hangzhou, Hangzhou, 310014) |
| Abstract: |
| Objective: To evaluate the value of ribavirin and interferon α1b in the treatment of children with hand-foot-mouth disease (HFMD). Methods: 488 children with HFMD in Children’s Hospital of Hangzhou from May 2012 to August 2012 were selected, which including 349 children with Mild HFMD and 139 children with severe HFMD, all the children were divided into interferon group, ribavirin group, control group according to different treatment. The interferon group had been given interferon α1b 0.5 μg/(kg·d) for 5 days, the ribavirin group had been given ribavirin injection 10 mg/(kg·d) for 7 days. The time of symptoms improvement, signs improvement and hospitalization time were compared, then the clinical outcomes were evaluated, the cerebrospinal fluid were taken for detecting cytokines by flow cytometry. Results: There were no difference in cooling time, foot rash subsided time, oral ulcers subside time, hospital stay time between interferon group, ribavirin group and control group (P> 0.05); the markedly effective rate, efficient rate and inefficient rate in interferon group, ribavirin group and control group had no difference (P>0.05); the IL-1β, IL-12p70 in three group had no difference before and after treatment (P>0.05), the CCL2/MCP-1, CCL5/RANTES, IL-10 in interferon group and ribavirin group during recovery phase were lower than acute phase (P<0.05). The CCL2/MCP-1 in control group during recovery phase were higher than acute phase (P<0.05), the MCP-1 of interferon group and the TNF-α of ribavirin group had no difference between recovery phase and acute phase, the other index in cerebrospinal fluid were lower during recovery phase than acute phase (P<0.05). Conclusion: The research does not show exact effect in the treatment of children with HFMD by ribavirin or interferon, but whether has impact on MCP-1 need further study. |
| Key words: hand-foot-mouth disease children ribavirin interferon α1b cerebrospinal fluid cytokines |
