摘要目的：比较不同剂量甲泼尼龙治疗小儿重症手足口病的临床效果。方法选取240例小儿重症手足口病患儿，按照不同的剂量将其分为大剂量组、中剂量组和小剂量组各80例。三组患儿均在常规治疗基础上给予不同剂量甲泼尼龙静脉滴注：大剂量组5～10 mg·kg －1·d －1，中剂量组3～5 mg·kg －1·d －1，小剂量组1～2 mg·kg －1·d －1。比较三组患儿的治疗效果。结果中剂量组发热持续（47．93±4．72）h、易惊缓解（45．54±2.42）h、机械通气（51．43±6．85）h、血压升高持续时间（53．66±7．62）h、心率恢复正常（52．45±7.84）h，均显著短于小剂量组和大剂量组（P ＜0．05）。中剂量组危重症发生率和上呼吸机的发生率均明显低于小剂量和大剂量组（P ＜0．05）。中剂量组肺水肿、肺出血发生率均明显低于小剂量组和大剂量组（P ＜0.05）。而三组低血钾、低血钙和消化道出血并发症比较，差异均无统计学意义（P ＞0．05）。结论中剂量的甲泼尼龙治疗小儿重症手足口病疗效显著，不良反应较少，值得临床推广。

abstractsObjective To compare the clinical effects of different doses of methylprednisolone therapy for children with severe hand,foot and mouth disease (HFMD).Methods According to different dosage methods, 240 children with severe HFMD were divided into large dose group,medium dose group and small dose group,80 cases in each group.The three groups were given different doses of methylprednisolone infusion on the basis of conventional treatment:large dose group(5 ~10mg·kg· -1 d -1 ),medium dose group(3 ~5 mg·kg· -1 d -1 ),small dose group (1 ~2mg · kg · -1 d -1 ).Results The time of fever sustaining,panic ease,mechanical ventilation,duration of hypertension and heart rate recovery of the medium -dose group were (47.93 ±4.72)h,(45.54 ±2.42)h,(51.43 ± 6.85)h,(53.66 ±7.62)h,(52.45 ±7.84)h,which were significantly shorter than those of the small -dose and large -dose group(all P <0.05).The incidence of turning to critically ill and the rate of ventilator use of the medium-dose group were significantly lower than those of the small -dose and large -dose group (all P <0.05 ).The incidence of pulmonary edema and pulmonary hemorrhage of the medium -dose group were significantly lower than those of the small -dose and large -dose group(all P <0.05).The differences among three groups were not statistically significant in the complications such as hypokalemia,hypocalcemia and gastrointestinal bleeding (all P >0.05 ). Conclusion Medium dose of methylprednisolone in the treatment of children with severe HFMD has significant effect and less adverse reactions,which is worthy of promotion.