目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 分析妊娠中期血清25(OH)D₃水平对妊娠期糖尿病(gestational diabetes mellitus,GDM)的预测价值。方法 选取2019年7月—2020年3月在广州市妇女儿童医疗中心及广东省计划生育专科医院进行产前检查的孕中期妇女,根据孕妇的空腹血糖(FBG)水平和口服糖耐量试验(OGTT)结果分为GDM组(100例)和对照组(320例)。分别测定两组孕妇的年龄、孕前BMI、空腹血糖、服糖后l h血糖、服糖后2 h血糖、空腹胰岛素及25(OH)D₃等指标,进行统计分析与比较。结果 GDM组维生素D不足及缺乏的发病率高于对照组(P＜0.05)。年龄、空腹胰岛素在两组之间无统计学差异(P＞0.05);GDM组25(OH)D₃水平低于对照组(P＜0.05);GDM组空腹血糖、服糖后1 h、2 h血糖及孕前BMI均高于对照组(P＜0.05)。血清25(OH)D₃水平与空腹血糖、服糖后1 h、2 h血糖呈负相关(P＜0.05),而与年龄、BMI及空腹胰岛素无显著相关性(P＞0.05)。25(OH)D₃水平与妊娠期糖尿病发生风险呈负相关。结论 妊娠中期血清25(OH)D₃水平降低可能增加GDM的发生风险,联合检测妊娠中期血清25(OH)D₃水平有助于GDM的早期预测。

Objective To analyze the predictive value of serum 25(OH)D₃ level in the second trimester of pregnancy for gestational diabetes mellitus. Methods From July 2019 to March 2020, pregnant women who had prenatal examinations in Guangzhou Women and Children's Medical Center and Guangdong Family Planning Hospital were selected and divided into GDM group (100 cases) and control group (320 cases) according to FBG level and oral glucose tolerance test (OGTT) results.The age, pre-pregnancy BMI, fasting blood glucose, l h blood glucose after taking sugar, 2 h blood glucose after taking sugar, fasting insulin, 25(OH)D₃ and other indicators of the two groups of pregnant women were measured, respectively, for statistical analysis and comparison. Results The incidence of vitamin D deficiency and deficiency in GDM group was higher than that in control group (P<0.05).There was no significant difference in age and fasting insulin between the two groups (P>0.05).The level of 25(OH)D₃ in the GDM group was lower than that in the control group (P<0.05).Fasting blood glucose, blood glucose at 1 h and 2 h after taking sugar and BMI before pregnancy were all higher in the GDM group than in the control group (P<0.05).Serum 25(OH)D₃ level was negatively correlated with fasting blood glucose and blood glucose at 1 h and 2 h after taking sugar (P<0.05), but not significantly correlated with age, BMI and fasting insulin (P>0.05).The level of 25(OH)D₃ was negatively correlated with the risk of gestational diabetes. Conclusion Reduced serum 25(OH)D₃ levels in the second trimester may increase the risk of GDM, and combined detection of serum 25(OH)D₃ levels in the second trimester is helpful for early prediction of GDM.

目的 探讨家庭医生契约式服务对婴儿生长发育及肺炎发生率的影响。方法 选取2019年7月—2020年2月龙凤社区出生的婴儿200例作为研究对象,随机分为签约组与未签约组,每组100例。其中,签约组婴儿接受家庭医生契约式服务,未签约组婴儿则接受社区常规儿童保健服务。记录两组婴儿出生后第1、3、6、9、12个月时的生长发育指标(身长、体质量)、神经心理发育指标(大动作、精细动作、个人-社会、语言、适应性)以及肺炎发生率,进行对比分析。结果 出生后第1个月和第3个月,两组婴幼儿身高与体质量差异无统计学意义(P＞0.05)。自出生后第6个月开始,签约组婴幼儿的身高与体质量水平均高于未签约组婴幼儿(P＜0.05)。两组中出生后1月龄的婴幼儿在发育商5项指标中差异均无统计学意义(P＞0.05)。在12月龄时,签约组婴幼儿的大动作、精细动作、个人-社会、语言、适应性5项指标评分均高于未签约组婴幼儿(P＜0.05)。截止出生后第12个月,签约组共发生2例肺炎患儿,肺炎发生率2%;未签约组发生10例肺炎患儿,肺炎发生率10%,高于签约组肺炎发生率。所有肺炎患儿均给予积极对症治疗后痊愈。结论 家庭医生契约式服务能够促进婴幼儿出生后第1年内身心发育水平,同时还能有效降低肺炎的发生风险,有利于婴幼儿身心全面、健康地发育和生长,具有比较显著的卫生和社会学价值,值得推广应用。

Objective To explore the effect of family doctor contract service on infant growth and development and incidence of pneumonia. Methods From July 2019 to February 2020, 200 infants in Longfeng community were selected as the research objects and randomly divided into contract group and non contract group, with 100 cases in each group. Among them, the infants in the contract group received the family doctor contract service, while the infants in the non signing group received the community routine child health care services. The growth and development indexes (body length, body weight), neuropsychological development indexes (big movements, fine movements, personal society, language, adaptability) and the incidence of pneumonia were recorded and analyzed in the first, third, sixth, ninth and twelfth months after birth. Results There were no significant differences in height and weight between the two groups at the first and third month after birth (P>0.05). From the 6th month after birth, the height and weight of infants in the signing group were higher than those in the non signing group (P<0.05). There were no significant differences in the 5 indexes of development quotient between the two groups (P>0.05). At the age of 12 months, the scores of big movement, fine movement, personal society, language and adaptability of infants in contract group were higher than those in non contract group (P<0.05). By the end of the 12th month after birth, there were 2 cases of pneumonia in the signing group, the incidence of pneumonia was 2%; in the non signing group, there were 10 cases of pneumonia, the incidence of pneumonia was 10%, which was higher than that of the signing group. All children with pneumonia were cured after active symptomatic treatment. Conclusion Family doctor contract service can promote the physical and mental development level of infants and young children in the first year after birth, at the same time, it can effectively reduce the risk of pneumonia, which is conducive to the comprehensive and healthy development and growth of infants and young children. It has significant health and sociological value and is worthy of promotion and application.

目的 分析晚期三阴性乳腺癌(TNBC)的危险因素并建立有效的预后列线图。方法 通过检索美国SEER(surveillance, epidemiology, and end results)数据库筛选晚期TNBC患者,采用单因素和多因素分析来确定晚期TNBC的独立预后因素,并以此构建了列线图,通过校准曲线检验和C指数(C-index)评估已建立的列线图。结果 共纳入4 687例晚期TNBC患者,与同期其他分子分型的乳腺癌相比较,TNBC的预后最差。单因素分析发现,年龄、性别、分期、手术、化疗、放疗、转移与更好的预后相关(P<0.05)。多因素分析发现年龄、性别、种族、分期、手术、化疗、放疗、各器官转移是患者预后的独立影响因素(P<0.05),并以此构建了列线图,其C-index为0.75(95％CI,0.71～0.79),校准图显示了预测的总生存期(OS)与观察到的OS之间的最佳一致性。结论 我们分析了晚期TNBC的临床特征,为TNBC患者的OS提供了一些预后因素,并根据这些预后因素制定了列线图,帮助临床医生进行风险管理并选择TNBC患者的长期生存策略。

Objective To analyze the risk factors of advanced triple-negative breast cancer (TNBC) and establish an effective prognostic nomogram. Methods Screening patients with advanced TNBC by searching the SEER (surveillance, epidemiology, and end results) database, using univariate and multivariate analysis to determine the independent prognostic factors of advanced TNBC, and constructing a nomogram based on it. Results A total of 4 687 patients with advanced TNBC were included. Compared with other types of breast cancer over the same period, TNBC had the worst prognosis. Univariate analysis found that age, gender, stage, surgery, chemotherapy, radiotherapy, and metastasis were associated with a better prognosis (P<0.05). Multivariate analysis found that age, gender, race, stage, surgery, chemotherapy, radiotherapy, and metastasis of the organs were independent factors affecting the prognosis of patients (P<0.05), and constructed a nomogram with a C-index of 0.75 ( 95% CI, 0.71～0.79). The calibration chart showed the best agreement between the predicted overall survival (OS) and the observed OS. Conclusion We analyzed the clinical features of advanced TNBC, provided some prognostic factors for the OS of TNBC patients, and developed a nomogram based on these prognostic factors to help clinicians manage risk and choose long-term survival strategies for TNBC patients.

目的 探索在全膝关节置换(TKA)围手术期中实施以中医透药+整体针疗法为特色的中西医结合加速康复方案的可行性,考察中医、西医加速康复措施在单独应用和联合应用时的促康复效能。方法 以在我院行首次单侧全膝关节置换术的患者为研究对象。根据围手术期干预差异分为四组:A组12例,根据指南采取传统常规的围手术期处理;B组12例,在A组基础上,采取了西医加速康复措施;C组14例,在A组基础上,采取了中医透药+整体针疗法;D组15例,兼采用西医加速康复措施和中医透药+整体针疗法。统计所有患者术后24小时、术后3天视觉模拟疼痛评分(VAS)和术前、术后2周膝关节功能评分(HSS)。并作以上数据的组间比较。结果 四组患者术后24 h VAS组间差异无统计学意义,术后3 d VAS组间总体差异有统计学意义:组间两两比较,B、C、D组均低于A组(P<0.05),B、C、D组间差异则无统计学意义。四组患者术前HSS组间差异无统计学意义,术后2周HSS组间总体差异有统计学意义:组间两两比较,B、C、D组均高于A组(P<0.05),A、B、C组均低于D组(P<0.05),B、C组间差异无统计学意义。结论 中医透药+整体针疗法在TKA围术期应用切实可行,与加速康复理念有机结合可有效缓解患者围术期疼痛,改善术后膝关节功能。

Objective To explore the feasibility of implementing the accelerated rehabilitation program of integrated traditional Chinese and western medicine featuring TCM and holistic acupuncture in the perioperative period of total knee arthroplasty (TKA),and investigate the effectiveness of accelerated rehabilitation under concept of recovery after surgery ERAS of traditional Chinese medicine and western medicine in single application and joint application. Methods The patients who underwent the first unilateral total knee arthroplasty in our hospital were studied. According to the interventions during the perioperative period, they were divided into 4 groups: 12 cases in group A, which were treated according to the guidelines and traditional perioperative treatment; 12 cases in group B, on the basis of group A, western medicine accelerated rehabilitation measures were taken; for the 14 case in group C, on the basis of group A, TCM penetration combinate with holistic acupuncture therapy was adopted; in group D, the combination of western medicine accelerated rehabilitation measures and the TCM therapy above were implemented in 15 cases. The visual analogue score (VAS)of all patients at 24 hours and 3 days after surgery were counted, and their knee function scores in hospital for special surgery (HSS scores) were recorded before and 2 weeks after the surgery. Comparisons of the data above between different groups were carried out. Results There was no statistically significant difference between the 4 groups in the VAS at 24 h after the operation, but statistically significant difference was found in the comparison of VAS at the 3rd day after the operation;In pairwise comparison, the 3rd day's VAS of group B, C and D were all lower than that of group A (P<0.05). There was no statistically significant difference between the 4 groups in the HSS score before the operation, but statistically significant difference was found in the comparison of HSS score at the 2nd week after the operation;In pairwise comparison, the 2nd week's HSSscore of group B, C and D were all higher than group A (P<0.05),and that of group A,B and C were all lower than that of group D (P<0.05). Conclusion The application of TCM penetration medicine combinated with holistic acupuncture in perioperative period of TKA is practical and feasible. The combination of western medicine accelerated rehabilitation measures and the TCM therapy can effectively relieve patients' perioperative pain and improve postoperative knee function.

目的 观察香芹酚的解酒护肝作用。方法 将实验小鼠随机分为实验组(低剂量香芹酚组,中剂量香芹酚组,高剂量香芹酚组),生理盐水对照组和阳性对照组,观察小鼠行为学,醉酒小鼠的醉酒时间和醉酒潜伏期,检测血液中的乙醇浓度和肝组织中的SOD和MDA,计算肝比重。结果 与实验组比较,低,中,高剂量组香芹酚分别能显著延长小鼠的醉酒潜伏期(P<0.05),同时,各剂量的香芹酚组均可使肝组织中丙二醛(MDA)含量降低(P<0.05),肝组织中超氧化物歧化酶(SOD)活性分别增加(P<0.05)。结论 香芹酚具有解酒护肝作用,其作用机理可能与抗氧化活性有关。

Objective To observe the effect of carvacrol on MDA and SOD in acute alcoholic liver injury. Methods The experimental mice were randomly divided into the experimental group (low-dose carvacrol group, medium-dose carvacrol group, high-dose carvacrol group), normal saline control group and positive control group. The behavior of the mice was observed, the time and incubation period of drunkenness of the mice were observed, the concentration of alcohol in blood and SOD and MDA in liver tissues were detected, and the specific gravity of the liver was calculated. Results Compared with the experimental group, carvacrol in the low, medium and high dose groups could prolong the intoxication incubation period of mice (P<0.05), meanwhile, the content of malonaldehyde (MDA) in liver tissues was reduced in the carvacrol group (P<0.05), and the activity of superoxide dismutase (SOD) in liver tissues was increased in the carvacrol group (P<0.05). Conclusion Carvacrol has antialcoholism and liver protecting effects, and its mechanism may be related to antioxidant activity.

目的 研究电针治疗对重性抑郁障碍患者的抑郁状态的影响。方法 本研究共分为3组,药物组、和药物+电针组及对照组(每组各50 例),药物组给予艾司西酞普兰抗抑郁治疗连续6周,药物+电针组在给予艾司西酞普兰抗抑郁治疗的基础上,进行电针治疗6周。比较治疗前后三组的HAMD 24 项评分,并对三组的HAMD 24 项评分与血清细胞炎症因子IL-1β、IL-2、IL-6、TNF-α水平进行相关性分析。采用多元逐步回归法,分析影响基线药物组和药物+电针组HAMD 24 项评分的主要因素。结果 与治疗前比较,药物组和药物+电针组患者治疗后HAMD 24 项评分均降低,差异有统计学意义(P＜0.05或P＜0.01),与药物组比较,治疗后药物+电针组HAMD 24 项评分较低,差异有统计学意义(P＜0.05或P＜0.01)。药物组HAMD 24 项评分与血清细胞炎症因子IL-6(r=0.335,P<0.001)、TNF-α(r=0.269,P<0.001)、IL-2(r=0.257,P=0.001)和IL-1β(r=0.205,P=0.021)呈正相关。药物+电针组HAMD24 项评分与血清细胞炎症因子IL-6(r=0.338,P<0.001)、TNF-α(r=0.271,P<0.001)、IL-2(r=0.255,P=0.015)和IL-1β呈正相关(r=0.208,P=0.026)。影响药物组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-1β、IL-2、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.585、0.516、0.452、0.318、-0.290、0.262(P＜0.05或P＜0.01)。影响药物+电针组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-2、IL-1β、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.592、0.521、0.448、0.323、-0.295、0.271(P＜0.05或P＜0.01)。结论 药物联合电针治疗能有效改善重性抑郁障碍患者的抑郁状态,细胞炎症因子与HAMD24 项评分相关,可影响重性抑郁障碍患者的抑郁状态。

Objective To explore the effect of electroacupuncture on patients with severe depression. Methods Patients was divided into three groups, acupuncture group, drug group and the control group. Each group had 50 patients. The drug group was treated with escitalopram for 6 weeks.The acupuncture group were treated with escitalopram and electroacupuncture for 6 weeks. We compared the HAMD24 among 3 groups before or after treatment. The correlation of the levels of IL-1 β, IL- 2, IL- 6, TNF-α and the total HAMD24 score among 3 groups were taken by the correlation analysis. And the main factors influencing the total HAMD24 score before the study were analyzed by the multiple inear step regression method. Results Compared with the pre-treatment group, the HAMD score of the drug group and the acupuncture group decreased after treatment, the difference was statistically significant (P<0.05 or P<0.01). Compared with the drug group, the HAMD score of the acupuncture group was lower after treatment; the difference was statistically significant (P<0.05 or P<0.01). The drug group, HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β (r=0.335, 0.269, 0.257 and 0.205, respectively, P<0.05 or P<0.01). The acupuncture group HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β(r=0.338, 0.271, 0.255 and 0.208, respectively, P<0.05 or P<0.01). The main factors influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors influencing the HAMD score of the drug group before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors of the acupuncture group influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.592,0.521,0.448,0.323,- 0.295,0.271(P＜0.05 or P＜0.01). Conclusion Escitalopram combination with electroacupuncture may improve the the depressive state. Inflammatory cytokines were associated with HAMD24 scores and it affects the depressive state of patients with major depressive disorder.

目的 探讨支气管肺类癌的CT表现,为临床诊断提供更多信息。方法 回顾性地分析我院8例经病理证实的支气管肺类癌患者的CT资料及临床表现,并复习相关文献。结果 8例CT表现均为肺内单发病灶,其中周围型2例,中央型6例,病理证实非典型类癌2例,典型类癌6例;6例边界清楚,且密度多均匀;2例呈分叶状,1例边缘毛糙、伴短毛刺;5例病灶内部见钙化灶,1例病灶内见脂肪成分,1例见少量胸积液;5例肿块表现为“冰山征”,2例表现为支气管腔内结节,1例病灶边缘毗邻支气管分支;6例出现阻塞性肺不张或肺实变;增强扫描5例强化较明显,CT值升高≥30HU,其中2例不典型类癌强化不均匀,2例见可见强化血管影;3例呈轻-中度强化表现。结论 支气管肺类癌的CT表现具有一定特征性,对于临床诊断有一定价值,但其确诊多需要依靠病理检查。

Objective To investigate the CT findings of bronchial carcinoid and to provide more information for clinical diagnosis. Methods The CT findings and clinicaldata were retrospectively analyzed in 8 patientsconfirmed by biopsy. Results All the 8 cases manifested as single round mass on CT images, including 2 peripheral lesions and 6 central lesions. It was proved that 2 atypical tumors and 6 typical tumors. CT findings of these cases consisted of well-defined border and uniform density(6 cases),lobulated contour(2 cases) and rough margin with short burr(1 case). 5 cases contained calcification,1 case contained fat component and 1 case contained a small amount of pleural lesionscould present as an “iceberg sign”(5 cases), intra-bronchial nodule(2 cases) or near the edge of the bronchus(1 case).The obstructive atelectasis or pulmonary consolidation was found in 6 cases. On CT contrast scanning, these lesions presented relatively significant enhancement(5 cases),usually the CT value increased ≥30HU, in which 2 cases of atypical carcinoid were inhomogeneous enhancement, and 2 cases showed enhanced vascular and mild to moderte enhancement(3 cases). Conclusion The CT findings of bronchial carcinoid have certain characteristics, which are certain value for clinical diagnosis, but the final diagnosis mostly depends on pathology.

目的 通过血常规分析和C反应蛋白(CRP)水平检测,探讨其对儿童甲型和乙型流感的辅助诊断价值,为临床治疗提供参考依据。方法 选择3 069名甲型流感患儿、2 307名乙型流感患儿、855名健康儿童,统计分析血常规参数以及CRP水平。采用ROC曲线分析血常规对甲乙型流感的区分效能。结果 甲组白细胞计数(WBC)均值高于正常组,乙组则相反,甲乙组中性粒细胞百分比(Neut%)、中性粒细胞与淋巴细胞百分比比值(NLR)、单核细胞百分比(Mono%)的均值高于正常组,甲乙组淋巴细胞百分比(Lymph%)、血小板计数(PLT)的均值低于正常组。甲组中性粒细胞计数(Neut#)、单核细胞计数(Mono#)、CRP、PLT的均值均高于乙组,Lymph%和淋巴细胞计数(Lymph#)的均值低于乙组。甲组在WBC>13×10⁹/L、Neut%>70.7、Lymph%<19.1的构成比高于乙组。NLR预测甲型流感临界值为2.08(敏感度为75.9%,特异度为89.4%),预测乙型流感临界值为2.11(敏感度为50.5%,特异度为89.8%)。结论 血常规参数和CRP水平变化可用于判断流感患儿是否存在细菌感染,指导临床用药;NLR作为一种新型预测标志物,其变化可以对区分甲型、乙型流感,尤其是甲型流感具有临床价值。

Objective Through blood analysis and C-reactive protein (CRP) level detection, to explore its value in the auxiliary diagnosis of influenza A and B in children, and to provide reference for clinical treatment. Methods 3 069 children with influenza A, 2 307 children with influenza B, and 855 healthy children were selected, and blood routine parameters and CRP levels were statistically analyzed. The ROC curve was used to analyze the discriminatory efficacy of blood routine on influenza A and B. Results The mean value of white blood cell count (WBC) in group A was higher than that in normal group, but in group B it had the opposite result. The percentage of neutrophils (Neut%), the ratio of neutrophils to lymphocytes (NLR), and the percentage of monocytes (the mean value of Mono%) is higher than that of normal group, and the mean value of lymphocyte percentage (Lymph%) and platelet count (PLT) of group A and B is lower than that of normal group. The mean values of neutrophil count (Neut#), monocyte count (Mono#), CRP and PLT in group A were higher than those in group B, and the mean values of Lymph% and lymphocyte count (Lymph#) were lower than those in group B. The composition ratios of group A in WBC>13×10⁹/L, Neut%>70.7, Lymph%<19.1 were higher than that in group B. The NLR predicted the critical value of influenza A was 2.08 (sensitivity 75.9%, specificity 89.4%), and the predicted influenza B threshold value was 2.11 (sensitivity 50.5%, specificity 89.8%). Conclusion Changes in blood routine parameters and CRP levels can be used to determine whether there is a bacterial infection in children with influenza and to guide clinical medication; NLR as a new predictive marker, its changes can distinguish influenza A or B. Especially in influenza A determination, it has clinical value.

目的 观察免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、白介素-6(IL-6)和CXC趋化因子13(CXC13)水平影响。方法 选取2017年1月—2020年3月本院收治的60例自身免疫性脑炎患者,采用随机数字表法分为观察组30例与对照组30例。对照组给予甲泼尼龙疗法,观察组在对照组结合免疫球蛋白治疗。两组均以4周后评价。比较两组疗效,治疗前后T淋巴细胞亚群、免疫球蛋白、IL-6、CXC13及简易智能精神状态检查量表(MMSE)变化。结果 观察组总有效率(83.33%)高于对照组(60.00%)(P<0.05)。观察组治疗后CD⁺₃、CD⁺₄和CD⁺₄/CD⁺₈高于对照组(P<0.05)。观察组治疗后血清IgA、IgG和IgM水平低于对照组(P<0.05)。观察组治疗后血清IL-6和CXC13水平低于对照组(P<0.05)。观察组治疗后MMSE评分高于对照组(P<0.05)。结论 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者疗效良好,且可增强机体细胞和体液免疫功能,降低IL-6和CXC13水平。

Objective To observe the effect of immunoglobulin combined with methylprednisolone on T lymphocyte subsets, immunoglobulin, interleukin-6 (IL-6) and CXC chemokine 13 (CXC13) in patients with autoimmune encephalitis. Methods 60 patients with autoimmune encephalitis admitted to our hospital from January 2017 to March 2020 were divided into 30 cases of observation group and 30 cases of control group. The control group was treated with methylprednisolone, and observation group was treated with immunoglobulin compared with the control group. The course of treatment in both groups was 4 weeks. The effects of the two groups were compared. The changes of T lymphocyte subsets, immunoglobulin, IL-6, CXC13 and MMSE before and after treatment were compared. Results Total effective rate (83.33%) of the observation group was higher than that of control group (60.00%) (P<0.05). After treatment, in the observation group, CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ were higher than that of control group (P<0.05); levels of serum IgA, IgG and IgM were lower than that of control group (P<0.05); serum levels of IL-6 and CXC13 were lower than that of control group (P<0.05); MMSE score was higher than that of control group (P<0.05). Conclusion Immunoglobulin combined with methylprednisolone is effective in the treatment of autoimmune encephalitis. It may enhance the cellular and humoral immune function, and reduce the levels of IL-6 and CXC13.