重型乙型脑炎患者肾上腺皮质激素的作用.DOCVIP

临床医学论文-重型乙型脑炎患者肾上腺皮质激素的作用 　【摘要】 目的 探讨地塞米松对乙型脑炎患儿的病情、预后及脑脊液α-肿瘤坏死因子(TNF-α)与干扰素(IFN)的影响。方法 把33例重型极期乙脑患儿随机分为两组,地塞米松组18例给予静脉地塞米松针4~5 d; 对照组15例则不用地塞米松。观察比较两组的临床过程和脑脊液TNF-α与IFN的变化。结果 入院时两组的主要临床特点和脑脊液TNF-α与IFN的水平相似, 4~5 d后地塞米松组的临床症状改善情况优于对照组,但两组的脑脊液TNF-α与IFN的水平却无明显改变,并经过一个月的观察地塞米松组的恢复期症状发生率也低于对照组。结论 对重型极期乙脑患儿给予静脉地塞米松可以改善病情,减轻症状,减少恢复期症状的发生。 　　【关键词】 乙脑;地塞米松;病情 　　【Abstract】 Objective To investigate the influence of adrenal cortical hormone on the patients condition, prognosis and the levels of TNF-α and TNF-γ in cerebrospinal fluid in children with epidemic encephalitis B.Methods 33 cases of severe type of patients with epidemic encephalitis B were divided into two groups randomly, i e dexamethasone-treated group (18) and the control group(15) . In the treated group, patients were treated with intravenous injection of dexamethasone at a dosage of 8 mg/kg/day for 0.4~0.8 or 5 days; while in the control, no dexammethasone was given. The clinical courses and the changes on levels of TNF-α and IFN-γ in cerebrospinal fluid were compared between these two groups of patients.Results It was demonstrated that the clinical courses and the levels of cytokines in cerebrospinal fluid at time of admission appeared to be similar, however, the improvement of clinical course in the-treated group was better than those of the control group. As to the levels of cytokines in cerebrospinal fluid, there were no significant difference between these two groups. In addition, after one month observation, the rate of symptom development in the convalescence of the treated group was lower than that of the control group.Conclusion From the above observations, it is evident that treatment with intravenous injection of dexamethasone in severe cases with epidemic encephalitis B can improve the clinical course, lessen the clinical symptoms and reduce the rate of development of symptoms in convalescence. 　　【Key words】 Epidemic encephalris B; Dexamethasone; Patients condition 　　 　　流行性乙型脑炎(epidemic encepha