摘要
背景肠系膜淋巴结炎(mesenteric lymphadenitis,ML)是儿童急性腹泻发生的主要原因,影响患儿身体健康.目前,其病因尚不完全清晰,一般认为因呼吸道病毒或细菌感染引起,与免疫功能低下密切相关.维生素D与复方谷氨酰胺被证实具有调节免疫的作用,故本研究将维生素D联合复方谷氨酰胺应用至ML患儿,尝试探讨其应用效果.目的探究维生素D联合复方谷氨酰胺治疗学龄前儿童ML的疗效及对细胞免疫功能的影响.方法选取2019-12/2022-12我院180例学龄前ML患儿,随机分为两组.对照组90例,采用复方谷氨酰胺治疗,研究组90例,采用维生素D联合复方谷氨酰胺治疗,均持续治疗7 d.比较两组治疗效果、不良反应、临床症状改善时间、治疗前后血清炎性因子[肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)、降钙素原(procalcitonin,PCT)、白介素-8(interleukin 8,IL-8)]、免疫功能指标[免疫球蛋白A(immunoglobulin A,IgA)、IgG、CD3^(+)、CD4^(+)/CD8^(+)]、影像学指标(淋巴结长径、短径),治疗结束后随访2 mo,统计比较两组腹痛复发率.结果研究组治疗总有效率92.22%(83/90)与对照组86.67%(78/90)比较,无显著差异(P>0.05);研究组发热消退、腹痛消失、恶心/呕吐消失、淋巴结肿大消失时间较对照组缩短(P<0.05);研究组治疗3 d后血清PCT、TNF-α、IL-8水平低于对照组(P<0.05);研究组治疗3 d后血清IgA、IgG、CD3^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05);研究组治疗3 d后淋巴结长径、短径短于对照组(P<0.05);研究组不良反应发生率2.22%(2/90)与对照组3.33%(3/90)比较,无显著差异,研究组腹痛复发率5.56%(5/90)低于对照组14.44%(13/90)(P<0.05).结论维生素D联合复方谷氨酰胺治疗学龄前儿童ML安全有效,能显著抑制患儿机体炎症反应,改善免疫功能,促进症状消退,加速病情恢复,且能降低复发率.
BACKGROUND Mesenteric lymphadenitis(ML)is a major cause of acute diarrhoea in children and affects their health.The etiology of ML is not fully understood and is generally thought to be caused by respiratory viral or bacterial infections,which are closely related to immunocompromise.Vitamin D and compound glutamine have been shown to have immune-regulating effects.This study was conducted to investigate the effects of vitamin D combined with compound glutamine in children with ML.AIM To evaluate the efficacy of vitamin D combined with compound glutamine in the treatment of ML in preschool children and analyze its influence on cellular immune function.METHODS A total of 180 preschool children with ML treated at our hospital from December 2019 to December 2022 were included and randomly divided into either a control group or a study group.The control group(90 cases)was treated with compound glutamine alone,and the study group(90 cases)was treated with vitamin D combined with compound glutamine for 7 d.The therapeutic effects,adverse reactions,time to improvement of clinical symptoms,serum inflammatory factors[tumor necrosis factor-α(TNF-α),procalcitonin(PCT),and interleukin-8(IL-8)],immune function indicators[immunoglobulin(Ig)A,IgG,CD3^(+)T cells,and CD4^(+)/CD8^(+)ratio],and imaging indicators(lymph)were compared between the two groups.The patients were followed for 2 mo after treatment,and the recurrence rate of abdominal pain was statistically compared between the two groups.RESULTS The total effective rate of the study group was 92.22%(83/90)compared with 86.67%(78/90)of the control group(P>0.05).Fever subsided,abdominal pain disappeared,nausea/vomiting disappeared,and lymph node enlargement disappeared in a shorter time in the study group than in the control group(P<0.05).The levels of serum PCT,TNF-α,and IL-8 in the study group were significantly lower than those in the control group after 3 days of treatment(P<0.05).The serum levels of IgA,IgG,CD3^(+)T cells and CD4^(+)/CD8^(+)ratio in the study group we
作者
郑静
郑盛华
应雪娜
Jing Zheng;Sheng-Hua Zheng;Xue-Na Ying(Department of Pediatrics,The First People’s Hospital of Daishan County,Zhoushan 316200,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2023年第18期782-790,共9页
World Chinese Journal of Digestology
关键词
肠系膜淋巴结炎
复方谷氨酰胺
维生素D
免疫功能
症状改善
复发率
Mesenteric lymphadenitis
Compound glutamine
Vitamin D
Immune function
Symptom improvement
Recurrence rate
