摘要
目的:探讨纤维支气管镜肺泡灌洗(BAL)联合阿奇霉素对支原体肺炎患儿炎症反应和免疫功能的影响。方法:回顾性分析2022年6月至2023年6月该院收治的90例支原体肺炎患儿的临床资料,根据治疗方案不同将其分为对照组和观察组各45例。对照组采用阿奇霉素序贯治疗,观察组在对照组基础上联合BAL治疗。比较两组临床疗效,治疗前后肺功能指标[潮气量、肺活量、呼气流量峰值(PEF)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)]、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、γ干扰素(IFN-γ)]、T细胞亚群指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,以及不良反应/并发症发生率。结果:观察组治疗总有效率为95.56%(43/45),高于对照组的82.22%(37/45),差异有统计学意义(P<0.05);治疗1周后,观察组潮气量、肺活量及PEF、TPTEF/TE、VPEF/VE、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,血清CRP、TNF-α、IL-6、IFN-γ、CD8^(+)水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应/并发症发生率比较,差异无统计学意义(P>0.05)。结论:BAL联合阿奇霉素治疗支原体肺炎患儿效果确切,能够有效改善肺通气功能,降低炎性因子水平,提高免疫功能,效果优于单用阿奇霉素治疗。
Objective:To investigate effects of fiberoptic bronchoscopy alveolar lavage(BAL)combined with Azithromycin on inflammatory response and immune function in children with mycoplasma pneumonia.Methods:The clinical data of 90 children with mycoplasma pneumonia admitted to this hospital from June 2022 to June 2023 were retrospectively analyzed.According to different treatment options,they were divided into control group and observation group,45 cases in each group.The control group was treated with Azithromycin sequential therapy,while the observation group was treated with BAL on the basis of that of the control group.The clinical efficacy,the lung function indexes[tidal volume,vital capacity,peak expiratory flow(PEF),peak time ratio(TPTEF/TE),ratio of volume at peak tidal expiratory flow to expiratory tidal volume(VPEF/VE)]levels,the serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interferon-γ(IFN-γ)]levels,the T cell subsets indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels before and after the treatment,and the incidence of adverse reactions/complications were compared between the two groups.Results:The total effective rate of the observation group was 95.56%(43/45),which was higher than 82.22%(37/45)of the control group,and the difference was statistically significant(P<0.05).After 1 week of treatment,the tidal volume,vital capacity,and the levels of PEF,TPTEF/TE,VPEF/VE,CD4^(+),CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the levels of CRP,TNF-α,IL-6,IFN-γand CD8^(+)were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions/complications between the two groups(P>0.05).Conclusions:BAL combined with Azithromycin is effective in the treatment of the children with mycoplasma pneumonia,which can effectively improve the lung ventilation function and reduce the levels of inflammatory factors and improv
作者
陈冉
CHEN Ran(Department of Pediatrics of Puyang People’s Hospital,Puyang 457000 Henan,China)
出处
《中国民康医学》
2024年第3期62-65,共4页
Medical Journal of Chinese People’s Health
关键词
纤维支气管镜
支气管肺泡灌洗
阿奇霉素
支原体肺炎
儿童
炎症反应
免疫功能
Fiberoptic bronchoscopy
Bronchoalveolar lavage
Azithromycin
Mycoplasma pneumonia
Children
Inflammatory response
Immune function
