摘要
目的探讨纤维支气管镜(FOB)介入治疗时机对伴气道内黏液栓塞肺炎支原体肺炎(MPP)患儿肺复张效果及炎性指标影响。方法回顾性分析2018年5月-2020年5月西安市儿童医院收治的98例MPP伴气道内黏液栓塞患儿病例资料,依照入院至行FOB治疗时间分为早期组(≤10 d)49例、晚期组(>10 d)49例,比较两组肺复张效果(呼吸力指标及血气分析指标)、炎性指标、T细胞亚群及临床总有效率。结果治疗前两组肺容积、肺静态顺应性(Cst)、动脉血氧分压(PaO_(2))、气道平台压(Pplat)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)指标比较差异无统计学意义(P>0.05)。治疗后,两组肺容积、Cst、PaO_(2)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)获得显著提升,且早期组显著高于晚期组;两组Pplat、TNF-α、IL-6、CRP、CD8^(+)获得显著降低,且早期组低于晚期组,差异均有统计学意义(P<0.05)。早期组临床总有效率(95.92%)显著高于晚期组(79.59%),差异有统计学意义(P<0.05)。结论早期行FOB介入治疗,对于改善肺复张,抑制炎性反应,提高免疫防御功能具有积极意义。
Objective To investigate the effects of fiber bronchoscope(FOB)interventional therapy at different timing in patients with Mycoplasma pneumoniae pneumonia(MPP)with intraptracheal mucus embolism and its influence on peripheral blood tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and T cell subsets.Methods Retrospective analysis was performed on the data of 98 cases of MPP with intraptracheal mucus embolism in Xi’an Children’s Hospital from May 2018 to May 2020.According to the time from admission to FOB treatment,they were divided into early group(≤10 d)and late group(>10 d).The effects of pulmonary renewal(respiratory force index and blood gas analysis index),inflammatory indexes,T cell subsets and clinical total response rate were compared between the two groups.Results Before the treatment,there were no statistically significant differences in lung volume,static lung compliance(Cst)and arterial partial pressure of oxygen(PaO_(2)),the plateau airway pressure(Pplat),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).After treatment,lung volume,Cst,PaO_(2),CD3^(+),CD4^(+),CD3^(+)/CD8^(+)of the two groups significantly increased,and were significantly higher in the early group than those in the late group(P<0.05);the Pplat,TNF-α,IL-6,CRP,CD8^(+)of the two groups significantly decreased,and were significantly lower in the early group than that in the late group(P<0.05).The total clinical response rate(95.92%)in early group was significantly higher than that in late group(79.59%)(P<0.05).Conclusion Early FOB intervention therapy had positive significance in improving pulmonary renewal,inhibiting inflammatory response and improving immune defense function.
作者
王贞
王军
孙芳
张雯
WANG Zhen;WANG Jun;SUN Fang;ZHANG Wen(Respiratory Medicine,Xi'an Children's Hospital,Xi'an,Shaanxi 710003;Infectious Disease,Xi'an Children's Hospital,Xi'an,Shaanxi 710003,China)
出处
《热带医学杂志》
CAS
2022年第3期387-391,449,共6页
Journal of Tropical Medicine
基金
陕西省重点研发计划(2020SF-183)
关键词
纤维支气管镜
时机
气道内黏液栓塞
肺炎支原体肺炎
Fiberoptic bronchoscopy
Timing
Mucus embolism in the airway
Mycoplasma pneumoniae pneumonia
