摘要
目的:分析纳洛酮联合阿昔洛韦治疗儿童病毒性脑炎的临床疗效及不良反应情况。方法:回顾性收集72例病毒性脑炎患儿的临床资料,分为两组,其中对照组36例给予阿昔洛韦治疗,观察组36例给予阿昔洛韦与纳洛酮联合治疗,分析比较两组患儿治疗后临床症状(抽搐、头痛、惊厥、意识障碍、脑膜刺激征)及脑脊液水平的恢复时间、治疗前及治疗7 d后血清炎症因子[C-反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)、肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、IL-6]的浓度水平、治疗过程中不良反应(注射部位疼痛、皮疹、肾功能异常、低血压、恶心)情况及治疗7 d后的总有效率等临床疗效指标,并行统计学检验。结果:(1)观察组患儿治疗后各临床症状及脑脊液水平的恢复时间均短于对照组(P<0.05)。(2)两组患儿治疗前血清中CRP、NSE、TNF-α、IL-1、IL-6的浓度水平具有一致性,经组间比较其差异均无统计学意义(P>0.05);且治疗7 d后上述血清炎症因子的浓度水平均低于治疗前(P<0.05)。(3)观察组患儿治疗7 d后上述血清炎症因子的浓度水平均低于对照组(P<0.05)。(4)两组患儿治疗过程中注射部位疼痛、皮疹、肾功能异常、低血压、恶心等不良反应发生率(观察组19.44%、对照组13.89%)具有一致性,其差异无统计学意义(P>0.05)。(5)观察组患儿治疗7 d后的总有效率(94.44%)高于对照组(75.00%),其差异具有统计学意义(P<0.05)。结论:纳洛酮联合阿昔洛韦治疗儿童病毒性脑炎,可以减少患儿临床症状及脑脊液水平的恢复时间,降低血清炎症因子水平,且联合治疗的不良反应发生率无明显增加,或可为临床治疗提供一定参考价值。
Objective:To analyze the clinical efficacy and adverse reactions of naloxone combined with acyclovir in the treatment of viral encephalitis in children.Methods:The clinical data of 72 children with viral encephalitis were analyzed retrospectively.Among them,36 cases treated with acyclovir were set as control group,while another 36 cases treated with naloxone combined with acyclovir were included into observation group.We recorded the clinical symptoms(convulsions,headaches,seizures,consciousness disturbance,meningeal irritation) and recovery time of cerebrospinal fluid after treatment,serum levels of inflammatory factors such as C-reactive protein(CRP),neurons specific enolase(NSE),tumor necrosis factor α(TNF-α),interleukin 1(IL-1),IL-6,etc.,before treatment and 7 days after treatment,adverse drug reactions during treatment,such as pain at the injection site,rash,abnormal kidney function,hypotension,nausea,etc.,and the total effective rate of treatment after 7 days.Results:(1)The recovery time of clinical symptoms and cerebrospinal fluid in the observation group were shorter than those in the control group(P<0.05).(2)The concentration levels of CRP,NSE,TNF-α,IL-1,and IL-6 in both groups before treatment were similar(P>0.05),and after 7 days of treatment,all these inflammatory factors decreased than before(P<0.05).(3)After 7 days of treatment,the levels of these serum inflammatory factors in observation group were significantly lower than those in control group(P<0.05).(4)The incidence of adverse drug reactions such as rash,abnormal renal function,hypotension,nausea,and pain at the injection site during the treatment in the two groups(19.44% in the observation group and 13.89% in the control group) were consistent,and the difference showed no statistical significance(P>0.05).(5) The total effective rate(94.44%) in the observation group after 7 days of treatment was higher than that of control group(75.00%)(P<0.05).Conclusion:Naloxone combined with acyclovir in the treatment of viral encephalitis in children can reduce the recovery time of clinical symptoms and cerebrospinal fluid level,reduce the level of serum inflammatory factors,and the incidence of adverse reactions in the combined treatment is not significantly increased.Combination of naloxone and acyclovir is valuable for clinical treatment.
作者
付细舟
姚宝珍
FU Xizhou;YAO Baozhen(Dept.of Pediatrics,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2021年第6期985-989,共5页
Medical Journal of Wuhan University
关键词
儿童病毒性脑炎
纳洛酮
阿昔洛韦
Viral Encephalitis in Children
Naloxone
Acyclovir
