摘要
目的探究阿莫西林-克拉维酸钾序贯治疗对反复下呼吸道感染患儿细胞间黏附分子-1(Intercellular adhesion molecule-1,ICAM-1)、血管细胞黏附因子-1(Vascular cell adhesion factor-1,VCAM-1)水平及体液免疫的影响。方法选取2018年1月-2019年6月襄阳市中心医院收治的142例反复下呼吸道感染患儿,通过随机数字表法分为试验组和对照组,各71例。试验组接受阿莫西林-克拉维酸钾序贯治疗,对照组接受阿莫西林-克拉维酸钾静脉滴注疗法,两组均治疗7~14 d。比较两组治疗前后炎症反应、体液免疫、细菌学培养结果,治疗期间不良反应。结果治疗后较治疗前比较,两组血清ICAM-1、VCAM-1、C-反应蛋白(C-reactive protei,CRP)水平均降低,试验组低于对照组(P<0.05)。治疗后较治疗前比较,两组血清免疫球蛋白(immunoglobulin G,IgG)、免疫球蛋白A(immunoglobulin A,IgA)以及免疫球蛋白M(immunoglobulin M,IgM)水平均升高,试验组高于对照组(P<0.05)。试验组的细菌清除率95.12%与对照组的细菌清除率92.50%比较无统计学差异(P=0.624)。治疗期间,试验组不良反应发生率9.86%低于对照组23.94%(P=0.025)。结论相较于阿莫西林-克拉维酸钾静脉滴注疗法,阿莫西林-克拉维酸钾序贯治疗可降低反复下呼吸道感染患儿血清ICAM-1、VCAM-1水平,改善机体免疫功能,降低不良反应发生风险,细菌清除率相当,值得临床推广应用。
OBJECTIVE To investigate the sequential treatment of amoxicillin-potassium clavulanate on the levels of intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion factor-1(VCAM-1) and humoral immunity in children with repeated lower respiratory infection. METHODS A total of 142 children with recurrent lower respiratory tract infections admitted to Xiangyang Central hospital between Jan. 2018 and Jun. 2019 were recruited and randomly divided into the observation group and control group, with 71 cases in each group. The observation group received sequential treatment with amoxicillin and clavulanate potassium;the control group received intravenous infusion of amoxicillin and clavulanate potassium. Both groups were treated for 7 to 14 days. The inflammatory response, immune function, and bacteriological culture results were compared between the two groups before and after the treatment;the adverse reactions during treatment were compared between the two groups. RESULTS The levels of serum ICAM-1, VCAM-1, and C-reactive protein(CRP) in the two groups after treatment were significantly lower than that before treatment;and the indexes in the observation group were significantly lower than that in control(P<0.05). Compared with before the treatment, the levels of serum immunoglobulin(IgG), immunoglobulin A(IgA) and immunoglobulin M(IgM) in the two groups were significantly higher than that after the treatment, and the indexes in the observation were significantly higher than that in the control group(P<0.05). The differences between bacterial clearance rate of 95.12% in the observation group and that of 92.50% in the control group were not significant(P=0.624). The incidence of adverse reactions during treatment in the observation group was significantly lower than that in the control group(9.86% vs 23.94%, P=0.025). CONCLUSION Compared with amoxicillin and clavulanate potassium intravenous infusion therapy, sequential treatment of amoxicillin and clavulanate potassium can reduce the levels of serum ICAM-1 and VC
作者
赵申
李俊杰
ZHAO Shen;LI Jun-jie(Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang,Hubei 441000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第23期3673-3676,共4页
Chinese Journal of Nosocomiology
基金
湖北省卫生健康委员会联合基金资助项目(WJ2019H14)。
关键词
反复下呼吸道感染
小儿
阿莫西林-克拉维酸钾
序贯治疗
细胞间黏附分子-1
血管细胞黏附因子-1
Repeated lower respiratory tract infections
Children
Amoxicillin and clavulanic acid
Continuous treatment
Intercellular adhesion molecule-1
Vascular cell adhesion factor-1
