ABSTRACT
To investigate the effect of high dose gamma globulin combined with naloxone in the treatment of severe viral encephalitis in children ,and its influence on nerve function and immune function.Methods From March 2012 to May 2017,103 children with viral encephalitis in the First People＇s Hospital of Wenling were randomly divided into observation group (53 cases) and control group (50 cases) according to the digital table.The control group was given routine treatment.The observation group was given naloxone combined with high dose gamma globulin on the basis of routine treatment.The therapeutic effect,clinical symptoms,serum neurological function and humoral immune function were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (92.45% vs.78.00%) (χ2 ＝4.319,P＜0.05).The clinical symptoms,signs disappearance time and hospitalization time of the observation group were significantly shorter than those of the control group [(2.17 ±0.56) d vs.(3.12 ±0.79) d;(2.25 ±0.31) d vs.( 3.87 ±0.93) d; (3.84 ±0.46)d vs.(5.31 ±0.69)d;(2.01 ±0.83)d vs.(3.86 ±1.21) d;(1.85 ±0.58) d vs.(2.79 ±0.77)d;(11.36 ±2.14)d vs.(13.05 ±1.85) d;(10.21 ±3.05) d vs.(13.85 ±3.72) d] ( t＝7.072,11.998,12.789, 9.093,7.024,4.276,5.444,all P＜0.05).After treatment,the serum NSE,S-100βand NGF levels of the two groups were significantly decreased [(12.64 ±1.22) ng／L vs.(18.95 ±2.15) ng／L, (0.85 ±0.24) ng／L vs. (1.69 ±0.35)ng／L,(0.17 ±0.05)ng／mL vs.(0.98 ±0.12)ng／mL,(16.38 ±1.38)ng／L vs.(19.04 ±2.78)ng／L, (1.22 ±0.30) ng／L vs.(1.70 ±0.41) ng／L,(0.33 ±0.10) ng／mL vs.(0.96 ±0.14) ng／mL] ( t ＝18.583, 14.010,45.361,6.239,6.878,25.58,all P＜0.05),and the serum neurological function indicators of the observation group were significantly lower than those of the control group ( t ＝14.592,6.931,10.358,all P ＜0.05).After treatment,the level of IgG in the two groups were significantly higher than those before treatment [(15.62 ±2.31)g／L vs.(9.12 ±1.74)g／L;(11.52 ±2.05)g／L vs.(8.97 ±1.56)g／L]( t＝16.363,6.999,all P＜0.05),and the IgG level in the observation group was significantly higher than that in the control group (P＜0.05).There were no signifi-cant changes in the levels of IgM in the two groups before and after treatment (all P＞0.05).Conclusion High-dose gamma globulin combined with naloxone can effectively improve the clinical efficacy of severe viral encephalitis
ABSTRACT
Objective@#To investigate the effect of high dose gamma globulin combined with naloxone in the treatment of severe viral encephalitis in children, and its influence on nerve function and immune function.@*Methods@#From March 2012 to May 2017, 103 children with viral encephalitis in the First People's Hospital of Wenling were randomly divided into observation group (53 cases) and control group (50 cases) according to the digital table.The control group was given routine treatment.The observation group was given naloxone combined with high dose gamma globulin on the basis of routine treatment.The therapeutic effect, clinical symptoms, serum neurological function and humoral immune function were compared between the two groups.@*Results@#The total effective rate of the observation group was significantly higher than that of the control group (92.45% vs.78.00%)(χ2=4.319, P<0.05). The clinical symptoms, signs disappearance time and hospitalization time of the observation group were significantly shorter than those of the control group [(2.17±0.56)d vs.(3.12±0.79)d; (2.25±0.31)d vs.(3.87±0.93)d; (3.84±0.46)d vs.(5.31±0.69)d; (2.01±0.83)d vs.(3.86±1.21)d; (1.85±0.58)d vs.(2.79±0.77)d; (11.36±2.14)d vs.(13.05±1.85)d; (10.21±3.05)d vs.(13.85±3.72)d](t=7.072, 11.998, 12.789, 9.093, 7.024, 4.276, 5.444, all P<0.05). After treatment, the serum NSE, S-100β and NGF levels of the two groups were significantly decreased[(12.64±1.22)ng/L vs.(18.95±2.15)ng/L, (0.85±0.24)ng/L vs.(1.69±0.35)ng/L, (0.17±0.05)ng/mL vs.(0.98±0.12)ng/mL, (16.38±1.38)ng/L vs.(19.04±2.78)ng/L, (1.22±0.30)ng/L vs.(1.70±0.41)ng/L, (0.33±0.10)ng/mL vs.(0.96±0.14)ng/mL] (t=18.583, 14.010, 45.361, 6.239, 6.878, 25.58, all P<0.05), and the serum neurological function indicators of the observation group were significantly lower than those of the control group (t=14.592, 6.931, 10.358, all P<0.05). After treatment, the level of IgG in the two groups were significantly higher than those before treatment[(15.62±2.31)g/L vs.(9.12±1.74)g/L; (11.52±2.05)g/L vs.(8.97±1.56)g/L](t=16.363, 6.999, all P<0.05), and the IgG level in the observation group was significantly higher than that in the control group(P<0.05). There were no significant changes in the levels of IgM in the two groups before and after treatment (all P>0.05).@*Conclusion@#High-dose gamma globulin combined with naloxone can effectively improve the clinical efficacy of severe viral encephalitis in children, help to improve the clinical symptoms and signs of children, at the same time help to restore the nervous function of children and improve the humoral immune function, which is worthy of clinical application.