摘要
目的分析维生素A、维生素D联合抗生素序贯疗法治疗儿童肺炎支原体肺炎的效果及对心肌酶谱、单核细胞Toll样受体4(toll like receptor 4,TLR4)/核因子-κB(nuclear factor kappa-B,NF-κB)信号通路分子表达的影响。方法选取收治的116例肺炎支原体肺炎患儿,随机分成对照组和观察组,各58例。对照组采用阿奇霉素序贯疗法治疗,观察组在对照组治疗的基础上联合维生素A、维生素D治疗,均连续治疗2个疗程。比较2组的临床疗效及治疗期间不良反应发生情况。检测治疗前后血清天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、肌酸激酶同工酶(creatine kinase isoenzymes,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)水平。检测外周血Th1、Th2细胞计数及血清中TLR4、NF-κB水平。结果治疗后,观察组的总有效率高于对照组(P<0.05)。2组LDH、CK-MB、CK、AST、TLR4和NF-κB水平低于治疗前(P<0.05),且观察组LDH、CK-MB、CK、AST、TLR4和NF-κB水平低于对照组(P<0.05)。2组Th1细胞比例均下降(P<0.05),但2组比较差异无统计学意义。2组Th2细胞比例均显著降低,且观察组低于对照组(P<0.05);2组Th1/Th2值明显升高,且观察组高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论维生素A、维生素D联合阿奇霉素序贯疗法治疗肺炎支原体肺炎患儿疗效明确,可降低心肌酶、TLR4、NF-κB水平,纠正Th1/Th2细胞免疫平衡,改善机体免疫状况。
Objective To analyze the curative effect of vitamin A,vitamin D combined with antibiotics sequential therapy in children with Mycoplasma pneumoniae pneumonia(MPP)and its influences on myocardial enzyme spectrum and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathways.Methods A total of 116 children with MPP admitted to the hospital.They were randomly divided into control group(n=58)and observation group(n=58).The control group was treated with azithromycin sequential therapy,while the observation group was additionally treated with vitamin A and vitamin D.All were continuously treated for 2 courses.The clinical curative effect and occurrence of adverse reactions during treatment were compared between the 2 groups.The levels of serum aspartate aminotransferase(AST),creatine kinase MB(CK-MB),lactate dehydrogenase(LDH)and creatine kinase(CK)were detected by full-automatic biochemical analyzer before and after treatment.The counts of peripheral blood Th1 and Th2 were detected by flow cytometry.The levels of serum TLR4 and NF-κB were detected by enzyme-linked immunosorbent assay.Results The total response rate in observation group was higher than that in control group(P<0.05).After treatment,the levels of LDH,CK-MB,CK,AST,TLR4 and NF-κB in both groups were decreased(P<0.05),which were lower in observation group than in control group(P<0.05).After treatment,the proportion of Th1 in both groups was decreased(P<0.05),but there was no significant difference between the 2 groups(P>0.05).After treatment,the proportion of Th2 in both groups was significantly decreased,which was lower in observation group than in control group(P<0.05).After treatment,the Th1/Th2 ratio in both groups was significantly increased,which was higher in observation group than in control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(P<0.05).Conclusion The curative effect of vitamin A,vitamin D combined with azithromycin sequential therapy is significant in children with
作者
王影
张勇
代树栋
刘晓宇
律洁
WANG Ying;ZHANG Yong;DAI Shudong;LIU Xiaoyu;LÜJie(Department of Pediatrics,Huanghua People’s Hospital,Huanghua 061100,China)
出处
《西北药学杂志》
CAS
2024年第2期211-215,共5页
Northwest Pharmaceutical Journal
基金
沧州市重点研发计划指导项目(编号:213106138)。
