Use of glucocorticoid in severe hand-foot-mouth disease and the therapeutic effects of different dose of glucocorticoid in Henan and Sichuan Province

Objective To investigate the use of glucocorticoid in severe hand-foot-mouth disease in Henan and Sichuan Province and to compare the therapeutic effects of different dose of glucocorticoid. Methods In this multicenter retrospective study, 320 cases of severe hand-foot-mouth disease, which were randomly sampled from Jan.to May 2011 in Henan and Sichuan Province were collected.The use of intravenous glucocorticoid was calculated.Accor-ding to the dose of corticosteroids which had been used, these cases were divided into 3 groups: the non-corticosteroids group, the low-dose group and the high-dose group.The cure rate, febrile duration, nervous system involvement duration, time of staying in hospital, vital signs and serum glucose in 3 groups were compared. Results Patients who used intravenous glucocorticoid accounted for 90.9%(291/320 cases), and only 29 patients had not used(9.1%). The cure rate among 3 groups were not significantly different(P>0.05). In the low-dose group and the high-dose group, the nervous system involvement duration, the febrile duration and time of staying in hospital were longer than those in the non-corticosteroids group(all P<0.05). Comparing the blood pressure among 3 groups on the first day and the third day of hospitalization, the diastolic blood pressure in the high-dose group was much higher than that in other 2 groups on the third day of hospitalization(all P<0.05). Conclusions Glucocorticoid is generally used in severe hand-foot-mouth disease in Henan and Sichuan Province.The high-dose glucocorticoid is more often used in the situation that fever, nervous system involvement are not relieved.Glucocorticoid can never improve the cure rate in patients with severe hand-foot-mouth disease or shorten the course, relieve clinical symptoms.The therapeutic effects of glucocorticoid in severe hand-foot-mouth disease are not confirmed.The therapy of high-dose glucocorticoid may increase medicinal side effects. Key words: Severe hand-foot-mouth disease; Enterovirus 71; Glucocorticoid; Treatment