目的 對比更昔洛韋分別聯(lián)合神經(jīng)節(jié)苷脂和丙種球蛋白治療小兒病毒性腦炎的臨床效果及安全性。方法 選取2010年1月-2015年12月收治的124例小兒病毒性腦炎患者，隨機分為觀察1組（42例）、觀察2組（43例）及對照組（39例）。觀察1組給予更昔洛韋聯(lián)合神經(jīng)節(jié)苷脂治療，觀察2組給予更昔洛韋聯(lián)合丙種球蛋白治療，對照組單純給予更昔洛韋治療，比較3組患者臨床療效，血清神經(jīng)元特異性烯醇化酶（NSE）及炎癥因子水平。結(jié)果 觀察1組的總有效率為95.24%，觀察2組的總有效率為93.02%，均顯著高于對照組的總有效率（79.48%）；觀察組（1、2）的頭痛、發(fā)熱、驚厥、意識模糊、腦膜刺激征、腦脊液異常等臨床癥狀消失時間以及住院天數(shù)均顯著短于對照組（P<0.05）；觀察1組在驚厥、意識模糊消失時間上顯著短于觀察2組。治療后，3組患者血清中NSE水平均較治療前明顯降低（P<0.05），且觀察組（1、2）患者血清NSE水平顯著低于對照組（P<0.05）；觀察1組的NSE水平與正常對照組無差異；觀察2組的NSE水平顯著高于正常組（P<0.05）。3組患者血清中白介素6（IL-6）、白介素1β（IL-1β）的水平均較治療前明顯降低（P<0.05），且觀察組（1、2）患者血清炎癥因子水平明顯低于對照組（P<0.05）。結(jié)論 更昔洛韋聯(lián)合神經(jīng)節(jié)苷脂和更昔洛韋聯(lián)合丙種球蛋白兩種方案均是治療小兒病毒性腦炎的有效措施，均能有效降低機體炎癥反應，更昔洛韋聯(lián)合神經(jīng)節(jié)苷脂具有更好的修復神經(jīng)損傷的功效，值得臨床推廣。

Objective To compare the clinical effect and safety evaluation of three different dose regimens for treating children with viral encephalitis. Methods Totally 126 cases treated in Xi'an Central Hospital from January 2010 to December 2015 were randomly divided into observation group 1 (ganciclovir combined with gangliosides, 42 cases), observation group 2 (ganciclovir combined with gamma globulin, 43 cases), and control group (39 cases). The clinical effect and levels of NSE, inflammatory cytokine were compared in the three groups. Results The total effective rate in observation group 1 was 95.24% and that of observation group 2 was 93.02%, which were significantly higher than that of control group (79.48%). The disappearance time of headache, fever, convulsions, clouding of consciousness, meningeal irritation sign, cerebrospinal fluid abnormalities, and length of stay in observation groups (both 1 and 2) were significantly shorter than those in control group (P<0.05); After therapy, the levels of NSE in three groups were obviously decreased compared with those before therapy (P<0.05), and those in observation group were significantly lower than the control group (P<0.05); the levels of inflammatory cytokine in all three groups were obviously decreased compared with those before therapy (P<0.05), and that of observation group 1 had no statistical difference with the normal group, whereas that in control group was significantly higher than the normal group (P<0.05). Conclusion Ganciclovir combined with gangliosides as well as ganciclovir combined with gamma globulin were both effective methods in treating children with viral encephalitis and could decrease levels of inflammatory cytokine. Ganciclovir combined with gangliosides could effectively repair nerve damage, which deserves clinical expansion.