航空航天医学杂志

目的 观察在自身免疫性脑炎患儿的临床治疗中，利妥昔单抗联合免疫球蛋白及甲泼尼龙冲击治疗的应用效果及对患儿免疫功能、炎性因子、症状转归的影响。方法 取2022年08月至2025年08月南阳市中心医院收治的自身免疫性脑炎患儿80例，按照电脑数字表法随机分组，对照组(40例)采用免疫球蛋白和甲泼尼龙冲击治疗，研究组(40例)采用利妥昔单抗联合免疫球蛋白及甲泼尼龙冲击治疗，对比组间疗效。结果 研究组总有效率、治疗后CD4+/CD8+值和CD3+、CD4+水平均高于对照组，免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、CD8+、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平均低于对照组，症状转归时间均短于对照组(P<0.05),不良反应组间比较无差异性(P>0.05)。结论 利妥昔单抗联合免疫球蛋白及甲泼尼龙冲击治疗能够显著促进自身免疫性脑炎患儿临床症状转归，改善其免疫功能，减轻炎症反应，提高治疗效率。

Objective Observation of the clinical treatment effect of rituximab combined with immunoglobulin and methylprednisolone shock therapy in children with autoimmune encephalitis, and its impact on the immune function, inflammatory factors, and symptom outcomes of the children.Methods Eighty children with autoimmune encephalitis admitted to Nanyang Central Hospital from August 2022 to August 2025 were randomly divided into two groups using a computer numerical table method. The control group(40 cases) received immunoglobulin and methylprednisolone shock therapy, while the study group(40 cases) received rituximab combined with immunoglobulin and methylprednisolone shock therapy. The efficacy between the groups was compared.Results The total effective rate, CD4+/CD8+value, CD3+and CD4+levels of the research group were higher than those of the control group. The levels of immunoglobulin A(IgA), immunoglobulin G(IgG), CD8+, interleukin-6(IL-6), and tumor necrosis factor alpha(TNF-α) were lower than those of the control group. The symptom recovery time was shorter than that of the control group(P<0.05), and there was no significant difference in adverse reactions between the groups(P>0.05).Conclusions Rituximab combined with immunoglobulin and methylprednisolone shock therapy can significantly promote the clinical symptom progression of children with autoimmune encephalitis, improve their immune function, alleviate inflammatory reactions, and enhance treatment efficiency.