摘要
目的 观察静脉注射丙种球蛋白 (IVIG)对严重全身感染和感染性休克患儿炎症细胞因子变化及临床疗效。 方法 对符合诊断标准的 2 5例严重全身感染 (简称感染组 )和 2 4例感染性休克 (简称休克组 )患儿进行前瞻性对照研究。IVIG按每次 40 0mg/kg给予 ,感染组每日 1次 ,共用 2～ 3d ;休克组应用 1次。应用前后观察临床效果并测定血清TNF α ,IL 6、IL 10和Ig、CD4、CD8。 结果 感染组和休克组各 12例进行了IVIG治疗。IVIG治疗前后比较 ,TNF α、IL 6明显下降 ,IgG明显升高 (P <0 0 5 ) ,IL 10下降 (P >0 0 5 )。与对照组比较 :疾病严重度评分、血培养阳性率、休克纠正时限和多系统脏器功能衰竭发生率均有显著改善。 结论
Objective To investigate the cytokine changes and clinical efficacy in IVIG therapy of severe sepsis and septic shock.Methods 25 cases of severe sepsis(sepsis group) and 24 of septic shock(shock group)were diagnosed and included in study group.IVIG were administered on the basis of 400 mg/(kg·dose).one times a day,lasting 2～3 days and single dose for shock group.Before and after IVIG treatment,TNF α、IL 6、IL 10、Ig、CD 4、CD 8 and CD\-4/CD\-8 were measured and clinical presentations were observed.Results 12 cases of sepsis and 12 cases of shock group were treated by IVIG.After IVIG therapy TNF α,IL 6 were significantly reduced and IgG increased( P <0 05);IL 10 were reduced( P >0 05).Compared with control group,the illness severity score,positive blood culture,the duration of shock and the mobidity of multiple organ function failure showed significantly improvement.Conclusion IVIG treatment modulates the immunomechanism in patients with severe sepsis and septic shock and improves their prognosis.
出处
《小儿急救医学》
2000年第4期183-186,共4页
Pediatric Emergency Medicine
