摘要
目的探讨甲泼尼龙琥珀酸钠联合肺泡灌洗治疗重症支原体肺炎(SMPP)患儿的效果及其对肺功能、T淋巴细胞亚群、炎症因子水平的影响。方法选择2020年1月至2023年1月武穴市第一人民医院收治的102例SMPP患儿作为研究对象,根据随机数表法将患儿分为研究组和对照组,每组51例。两组患儿均接受常规对症治疗,对照组在此基础上给予甲泼尼龙琥珀酸钠治疗,观察组在对照组治疗的基础上联合肺泡灌洗治疗,均连续治疗4周。比较两组患儿的治疗效果和治疗前后的肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气中期流量(MMEF)]、T淋巴细胞亚群[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]、炎症因子[白细胞介素-8(IL-8)、γ-干扰素、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)],比较两组患儿治疗期间的不良反应发生情况。结果观察组患儿的治疗总有效率为94.12%,明显高于对照组的78.43%,差异有统计学意义(P<0.05);治疗前,两组患儿的FVC、FEV1、PPEF水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的FVC、FEV1、PPEF均显著升高,且观察组分别为(2.72±0.51)L、(2.98±0.41)L、(1.81±0.33)L,明显高于对照组的(2.12±0.48)L、(2.31±0.38)L、(1.52±0.30)L,差异均具有统计学意义(P<0.05);治疗前,两组患儿的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的CD4^(+)、CD4^(+)/CD8^(+)均明显升高,且观察组分别为(37.92±5.01)%、(1.89±0.34)%,明显高于对照组的(32.38±4.87)%、(1.56±0.27)%,但两组患儿的CD8^(+)明显降低,且观察组为(21.21±3.01)%,明显低于对照组的(25.02±2.74)%,差异均有统计学意义(P<0.05);治疗前,两组患儿的IL-8、γ-干扰素、CRP、TNF-α水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的IL-8、γ-干扰素、CRP、TNF-α均明显降低,且观察组分别为(10.38±2.10)ng/L、(21.09±2.98)ng/L、(1.98±0.31)mg/L
Objective To explore the effect of methylprednisolone sodium succinate combined with alveolar lavage in the treatment of severe Mycoplasma pneumonia(SMPP)in children,and its impact on lung function,T lymphocyte subsets,and inflammatory cytokine levels.Methods A total of 102 children with SMPP admitted to Wuxue First People's Hospital from January 2020 to January 2023 were selected as the research subjects.According to the random number table method,the children were divided into a study group and a control group,with 51 cases in each group.On the basis of routine symptomatic treatment,children in the control group received treatment with methylprednisolone sodium succinate,and children in the observation group received alveolar lavage on the basis of the control group,continuously for 4 weeks.The treatment efficacy and lung function indicators[forced vital capacity(FVC),forced expiratory volume at 1 second(FEV1),maximum mid expiratory flow(MMEF)],T lymphocyte subsets[CD4^(+),CD8^(+),CD4^(+)/CD8^(+)],inflammatory factors[interleukin-8(IL-8),y-interferon,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the two groups.The incidence of adverse reactions during treatment between two groups of pediatric patients were compared.Results The total effective rate in the observation group was 94.12%,which was significantly higher than 78.43%in the control group(P<0.05).Before treatment,there was no significant difference in the levels of FVC,FEV1 and PPEF between the two groups(P>0.05).After treatment,the FVC,FEV1,and PPEF of two groups of children increased,and the FVC,FEV1,and MMEF in the observation group were(2.72±0.51)L,(2.98±0.41)L,(1.81±0.33)L,which were higher than(2.12±0.48)L,(2.31±0.38)L,and(1.52±0.30)L in the control group(P<0.05).Before treatment,there was no significant difference in the levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).After treatment,the CD4^(+)and CD4^(+)/CD8^(+)levels in the two groups increased,and the l
作者
张明
吴佳伦
郭正平
ZHANG Ming;WU Jia-lun;GUO Zheng-ping(Department of Pediatrics,Wuxue First People's Hospital,Huanggang 435400,Hubei,CHINA)
出处
《海南医学》
CAS
2024年第4期472-476,共5页
Hainan Medical Journal
关键词
重症支原体肺炎
甲泼尼龙琥珀酸钠
肺泡灌洗
肺功能
T淋巴细胞
炎症因子
Severe mycoplasma pneumonia
Methylprednisolone sodium succinate
Pulmonary alveolar lavage
Lung function
T lymphocytes
Inflammatory factors
