摘要
目的:探究丙种球蛋白与阿奇霉素治疗重症肺炎支原体肺炎(SMPP)患儿的效果,并分析对患儿C-反应蛋白(CRP)、T淋巴细胞亚群以及免疫球蛋白水平的影响。方法:前瞻性的选取2017年2月至2019年2月我院儿科收治的190例SMPP患儿作为研究对象,以随机数字表法简单随机分成两组,对照组(n=95)为阿奇霉素治疗,观察组(n=95)为丙种球蛋白联合阿奇霉素;记录两组患儿临床效果(时间指标、肺功能指标),分析干预前后CRP、免疫球蛋白及T淋巴亚细胞群,并比较安全性。结果:临床效果上,观察组退热时间、止咳时间、啰音消失时间及住院时间分别为(2.58±0.78)d、(2.47±0.63)d、(3.95±1.15)d、(7.87±1.28)d,均显著低于对照组的(3.72±1.31)d、(4.84±1.41)d、(6.35±2.25)d、(10.28±3.28)d,差异有统计学意义(P<0.05);观察组的FEV1、FVC、MMEF分别为(65.41±6.14)%、(60.30±5.43)%、(65.96±7.19)%,均显著高于对照组的(51.67±5.46)%、(55.55±6.74)%、(52.25±7.25)%,差异有统计学意义(P<0.05)。两组患儿治疗后CRP、CD8^+均显著降低,CD4^+、CD4^+/CD8^+、IgA、IgG、IgM均显著升高,差异有统计学意义(P<0.05);治疗后观察组CRP、CD8^+分别为(10.86±5.72)mg/L、(28.64±2.44)%,显著低于对照组的(19.32±6.09)mg/L、(30.80±4.30)%,差异有统计学意义(P<0.05);CD4^+、CD4^+/CD8^+、IgA、IgG、IgM分别为(49.39±6.95)%、(1.88±0.65)%、(2.95±0.49)g/L、(13.37±2.80)g/L、(1.63±0.38)g/L,高于对照组的(44.87±6.31)%、(1.51±0.53)%、(2.41±0.48)g/L、(11.06±2.18)g/L、(1.34±0.38)g/L,差异有统计学意义(P<0.05)。两组患儿均有不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丙种球蛋白联合阿奇霉素可显著提高临床效果,改善患儿T淋巴细胞亚群功能,并提高免疫球蛋白表达水平。
Objective:To explore the curative effectiveness of gamma globulin and azithromycin in treating severe pediatric mycoplasma pneumoniae pneumonia,and to analyze their effects on the levels of CRP,T lymphocyte subsets and immunoglobulin.Methods:190 cases admitted in our hospital from February 2017 to February 2019 were selected prospectively and randomly divided into 2 groups with random number table method.The control group(n=95)was treated with azithromycin,and the observation group(n=95)was administered gamma globulin combined with azithromycin.Records were made of clinical effect of two groups(time index,pulmonary function index).Analysis was made on changes of CRP,immunoglobulin and T cells before and after interventional treatment.And the security of both treatments was compared.Results:Clinical effect was found better for the observation group,whose fever clearance time,the disappearance time of cough and pulmonary rales,and length of hospital stay were respectively(2.58±0.78)d,(2.47±0.63)d,(3.95±1.15)d,(7.87±1.28)d,significantly lower than in the control group(3.72±1.31)d,(4.84±1.41)d,(6.35±2.25)d,(10.28±3.28)d,and the difference was statistically significant(P<0.05).FEV1,FVC and MMEF in the observation group were(65.41±6.14)%,(60.30±5.43)%and(65.96±7.19)%,respectively,which were significantly higher than those in the control group(51.67±5.46)%,(55.55±6.74)%and(52.25±7.25)%,with statistically significant differences(P<0.05).CRP and CD8^+were significantly decreased in both groups after treatment,and CD4^+,CD4^+/CD8^+,IgA,IgG and IgM were significantly increased(P<0.05).After treatment,CRP and CD8^+in the observation group were(10.86±5.72)mg/L and(28.64±2.44)%,respectively,which were significantly lower than those in the control group(19.32±6.09)mg/L and(30.80±4.30)%,with statistically significant differences(P<0.05).CD4^+,CD4^+/CD8^+,IgA,IgG and IgM of the observation group were(49.39±6.95)%,(1.88±0.65)%,(2.95±0.49)g/L,(13.37±2.80)g/L,(1.63±0.38)g/L,respectively,higher than the control
作者
谢诚
樊映红
艾涛
刘燕茹
王丽
罗荣华
赖华
XIE Cheng;FAN Yinghong;AI Tao(Women and Children's Hospital Affiliated to Medical College of University of Electronic Science and Technology / The Center of Women and Children in Chengdu, Sichuan Chengdu 610091, China)
出处
《河北医学》
CAS
2020年第9期1446-1450,共5页
Hebei Medicine
基金
四川省卫生和计划生育科研课题,(编号:16PJ071)。
