海南医科大学学报

目的:探讨匹多莫德联合利巴韦林治疗小儿手足口病对炎性因子、T淋巴细胞亚群、免疫球蛋白、乳酸、D-二聚体和降钙素原的影响。方法:选取我院因手足口病需治疗患儿108例,按入院时间分为2组,每组54例,设置为观察组和对照组,两组患儿均予以隔离治疗,观察组予以匹多莫德联合利巴韦林治疗,对照组予以利巴韦林治疗,于入院时和治疗6天后分别抽取静脉血5mL,比较两组炎性因子、T淋巴细胞亚群、免疫球蛋白、乳酸、D-二聚体和降钙素原。结果:两组治疗前炎性因子、T淋巴细胞亚群、免疫球蛋白、乳酸、D-二聚体和降钙素原均无统计学差异(P>0.05)。治疗后观察组和对照组CRP、IL-6和TNF-α均低于治疗前(P<0.05),观察组治疗后CRP、IL-6和TNF-α均明显低于对照组,差异比较有显著性(P<0.05)。对照组治疗后CD3、CD4和CD4/CD8、IgG、IgA和IgM均显著高于本组治疗前,差异具有统计学意义(P<0.05);观察组治疗后CD3、CD4和CD4/CD8、IgG、IgA和IgM均明显高于对照组,差异比较有显著性(P<0.05)。两组治疗后乳酸、D-二聚体和降钙素原均显著低于本组治疗前,差异具有统计学意义(P<0.05);观察组治疗后乳酸、D-二聚体和降钙素原均显著低于对照组治疗后,差异具有统计学意义(P<0.05)。结论:匹多莫德联合利巴韦林治疗小儿手足口病临床效果较好,可有效降低炎性反应,增强免疫功能,改善临床生化指标,推荐临床广泛推广应用。

Objective:To observe the effects of pidotimod combined with ribavirin on inflammatory factors,T lymphocyte subsets,immunoglobulin,lactate,D-dimer and procalcitonin in children with hand-foot-mouth disease.Methods:108 children with foot-hand-and-mouth epidemic in our hospital from Jan.2013-Dec.2016 were divide into the observation group and the control group,each groups has 54 cases.Two groups of children were treated with isolation,the observation group was given pidotimod combined with ribavirin,the control group was treated with ribavirin.5 ml venous blood of two group patients were collected at admission and after 6 days treatment,respectively,to compare inflammatory factor,T lymphocyte subsets,immunoglobulin,lactate,D-dimer and procalcitonin in two groups.Results:Before treatment,the levels of inflammatory factor,T lymphocyte subsets,immunoglobulin,lactate,D-dimer and procalcitonin of two groups were not statistically significant(P>0.05).Compared with groups after treatment,the levels of CRP、IL-6和 TNF-αwere lower than that before treatment(P<0.05),CRP(2.23±0.37)mg/L,IL-6(21.24±9.81)pg/ml and TNF-α(56.97±50.36)pg/ml levels in observation group after treatment were significantly lower than those in control group,the difference was statistically significant(P<0.05).After treatment,the levels of CD3,CD4,CD4/CD8,IgG,IgA and IgM in control group were significantly higher than that before treatment,the difference was statistically significant(P<0.05);After treatment,the levels of CD3(51.26±10.27)%,CD4(36.36±4.09)% and CD4/CD8(1.60±0.47),IgG(10.24±1.82)mg/L,IgA(1.30±0.31)mg/L and IgM(1.48±0.30)mg/L in observation group were significantly higher that in control group,the difference was statistically significant(P <0.05).After treatment,the levels of lactate,D-dimer and procalcitonin in two groups were significantly lower than that before treatment,the difference was statistically significant(P<0.05);After treatment,the levels of lactate(1.19±0.20)mmol/L,D-dimer(150.23±27.21)ng/mL,and procalcitonin(0.08±0.02)ng/mL in observation group were significantly higher that in control group,the difference was statistically significant(P<0.05).Conclusion:Pidotimod combined with ribavirin has a pronounced effect on children with hand-foot-mouth disease,which can effectively reduce the body's inflammatory response,enhance immune function,improve clinical biochemical indicators,and should be widely recommended for clinical use.