匹多莫德辅助治疗细菌感染性肺炎的疗效及其对患儿血清炎性因子和Th1/Th2细胞因子的影响
|
摘要
目的观察匹多莫德辅助治疗细菌感染性肺炎的临床疗效,并探讨其对患儿血清炎性因子和Th1/Th2细胞因子影响。方法随机选择2016年3月至2018年5月上海市金山区亭林医院儿科收治的91例细菌感染性肺炎患儿,并按照入院先后顺序分为两组,2017年4月以前入院患儿纳入对照组(n=45),采用常规治疗,2017年4月以后入院患儿纳入观察组(n=46),在对照组基础上加匹多莫德辅助治疗,治疗2个月后,比较两组患儿的临床疗效、症状改善时间、炎性因子和Th1/Th2细胞因子含量的差异。结果观察组患儿的临床治疗总有效率为95.65%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);观察组患儿的发热消退时间、咳嗽消失时间、肺部啰音消失时间分别为(2.52±1.13) d、(4.82±2.64) d、(6.13±2.71) d,均明显短于对照组的(3.21±1.32) d、(6.64±2.91) d、(7.93±3.06) d,差异均有统计学意义(P<0.05);治疗前两组患儿的Th1细胞因子干扰素γ(INF-γ)、Th2细胞因子白介素-4 (IL-4)、INF-γ/IL-4水平比较差异均无统计学意义(P>0.05);治疗后两组患儿INF-γ、IL-4、INF-γ/IL-4均明显改善,但观察组改善程度更明显,差异均有统计学意义(P<0.05);两组患儿治疗前的降钙素原(PCT)、CRP及白细胞(WBC)比较差异均无统计学意义(P>0.05);治疗后两组患儿的上述指标均有所好转,其中观察组明显优于同期对照组,差异均有统计学意义(P<0.05)。结论匹多莫德辅助治疗能够提升细菌感染性肺炎患儿临床疗效,改善机体炎症反应及扭转Th1/Th2系统失衡状态,具有临床推广应用价值。
Objective To observe the clinical efficacy of Pidotimod in adjunctive therapy for bacterial infectious pneumonia, and to explore its effect on serum inflammatory factors and Th1/Th2 cytokines in children.Methods A total of 91 children with bacterial infection pneumonia admitted to the Department of Pediatrics at Shanghai Jinshan Tinglin Hospital from March 2016 to May 2018 were randomly selected and divided into two groups according to the order of admission. Children admitted to the hospital before April 2017 were included in the control group(n=45) with routine treatment. Children admitted to the hospital after April 2017 were included in the observation group(n=46) and given adjunctive therapy with pidotimod based on the treatment of the control group. After 2 months of treatment, the clinical efficacy, symptom improvement time, inflammatory factors and Th1/Th2 cytokine levels were compared between the two groups. Results The total effective rate in the observation group was 95.65%, which was significantly higher than 77.78% in the control group(P<0.05). The time of fever regression, the time of cough disappearance,and the disappearance time of lung rales in the observation group were respectively(2.52±1.13) d,(4.82±2.64) d, and(6.13±2.71) d, which were significantly shorter than corresponding(3.21±1.32) d,(6.64±2.91) d,(7.93±3.06) d in the control group(P<0.05). There were no significant differences in the levels of Th1 cytokine interferon gamma(INF-γ),Th2 cytokine interleukin-4(IL-4), and INF-γ/IL-4 ratio between the two groups before treatment; while INF-γ, IL-4,and INF-γ/IL-4 ratio were significantly improved in the two groups, and the improvements in the observation group were more significant(P<0.05). There were no significant differences in procalcitonin(PCT), C-reactive protein(CRP),and white blood cells(WBC) between the two groups(P>0.05); while after treatment, the above indicators were improved in both groups, and the observation group was significantly better than the control group. Conclusion Adjuvant therapy with Pidotimod can improve the clinical efficacy of children with bacterial infectious pneumonia, improve the body's inflammatory response and reverse the imbalance of Th1/Th2 system, and have clinical application value.
Objective To observe the clinical efficacy of Pidotimod in adjunctive therapy for bacterial infectious pneumonia, and to explore its effect on serum inflammatory factors and Th1/Th2 cytokines in children.Methods A total of 91 children with bacterial infection pneumonia admitted to the Department of Pediatrics at Shanghai Jinshan Tinglin Hospital from March 2016 to May 2018 were randomly selected and divided into two groups according to the order of admission. Children admitted to the hospital before April 2017 were included in the control group(n=45) with routine treatment. Children admitted to the hospital after April 2017 were included in the observation group(n=46) and given adjunctive therapy with pidotimod based on the treatment of the control group. After 2 months of treatment, the clinical efficacy, symptom improvement time, inflammatory factors and Th1/Th2 cytokine levels were compared between the two groups. Results The total effective rate in the observation group was 95.65%, which was significantly higher than 77.78% in the control group(P<0.05). The time of fever regression, the time of cough disappearance,and the disappearance time of lung rales in the observation group were respectively(2.52±1.13) d,(4.82±2.64) d, and(6.13±2.71) d, which were significantly shorter than corresponding(3.21±1.32) d,(6.64±2.91) d,(7.93±3.06) d in the control group(P<0.05). There were no significant differences in the levels of Th1 cytokine interferon gamma(INF-γ),Th2 cytokine interleukin-4(IL-4), and INF-γ/IL-4 ratio between the two groups before treatment; while INF-γ, IL-4,and INF-γ/IL-4 ratio were significantly improved in the two groups, and the improvements in the observation group were more significant(P<0.05). There were no significant differences in procalcitonin(PCT), C-reactive protein(CRP),and white blood cells(WBC) between the two groups(P>0.05); while after treatment, the above indicators were improved in both groups, and the observation group was significantly better than the control group. Conclusion Adjuvant therapy with Pidotimod can improve the clinical efficacy of children with bacterial infectious pneumonia, improve the body's inflammatory response and reverse the imbalance of Th1/Th2 system, and have clinical application value.
引文
[1]王永霞,王霞,王宝力,等.108例小儿感染性肺炎痰培养病原菌分布特点与耐药分析[J].中国实验诊断学,2013,17(12):2236-2237.
[2]刘德二.顺尔宁联合丙卡特罗治疗小儿支原体肺炎合并哮喘急性发作的疗效及对气道细胞因子的影响分析[J].中国妇幼保健,2015,30(17):2832-2834.
[3]江梅,刘冬冬,黎毅敏.呼吸机相关性肺炎诊疗指南循证解读[J].中国循证医学杂志,2016,20(1):33-35.
[4]马英.盐酸氨溴索治疗小儿肺炎56例疗效观察[J].医学信息旬刊,2011,24(23):689-689.
[5]张爱荣.小儿反复呼吸道感染临床特点与治疗分析[J].山西医药杂志,2014,11(17):2068-2069.
[6]盛放.儿童社区获得性肺炎流行病学特点及血清降钙素原水平临床分析[J].中华医院感染学杂志,2013,23(6):1400-1402.
[7]郭玮,田曼.儿童重症肺炎的病原学特点及诊治进展[J].国际呼吸杂志,2017,37(3):216-220.
[8]陈小燕,周卫萍.反复呼吸道感染患儿的病原菌分布与免疫功能监测[J].中华医院感染学杂志,2016,26(19):4521-4523.
[9]陈佑生.重组人干扰素α-1b联合匹多莫德对反复呼吸道感染患者免疫功能的影响[J].现代中西医结合杂志,2015,24(29):3210-3212.
[10]尹兆强,冯雪亮,苑昭奖,等.严重腹腔感染患者血清炎性指标表达水平与病情严重程度的相关性分析[J].疑难病杂志,2018,14(6):22-23.
[11]鲍登,常小红,谢加利.降钙素原在呼吸系统疾病诊断中的应用[J].临床肺科杂志,2014,19(1):137-139.
[12]林艳,李微,黄颖璇,等.血清PCT与hs-CRP对新生儿细菌感染性肺炎的诊断价值[J].海南医学,2017,28(10):1627-1628.
[13]徐爽,庄金宝,艾清,等.快速C反应蛋白联合血常规检测提高儿童上呼吸道感染诊断的临床价值[J].中国实验诊断学,2013,17(8):1474-1475.
[14]鲁红春.匹多莫德联合常规药物治疗对反复呼吸道感染儿童感染状态、免疫功能的影响[J].海南医学院学报,2017,23(19):14-15.
[15]郝丽.新生儿细菌性肺炎和轮状病毒感染T淋巴细胞亚群及细胞因子变化分析[D].合肥:安徽医科大学,2014.
[2]刘德二.顺尔宁联合丙卡特罗治疗小儿支原体肺炎合并哮喘急性发作的疗效及对气道细胞因子的影响分析[J].中国妇幼保健,2015,30(17):2832-2834.
[3]江梅,刘冬冬,黎毅敏.呼吸机相关性肺炎诊疗指南循证解读[J].中国循证医学杂志,2016,20(1):33-35.
[4]马英.盐酸氨溴索治疗小儿肺炎56例疗效观察[J].医学信息旬刊,2011,24(23):689-689.
[5]张爱荣.小儿反复呼吸道感染临床特点与治疗分析[J].山西医药杂志,2014,11(17):2068-2069.
[6]盛放.儿童社区获得性肺炎流行病学特点及血清降钙素原水平临床分析[J].中华医院感染学杂志,2013,23(6):1400-1402.
[7]郭玮,田曼.儿童重症肺炎的病原学特点及诊治进展[J].国际呼吸杂志,2017,37(3):216-220.
[8]陈小燕,周卫萍.反复呼吸道感染患儿的病原菌分布与免疫功能监测[J].中华医院感染学杂志,2016,26(19):4521-4523.
[9]陈佑生.重组人干扰素α-1b联合匹多莫德对反复呼吸道感染患者免疫功能的影响[J].现代中西医结合杂志,2015,24(29):3210-3212.
[10]尹兆强,冯雪亮,苑昭奖,等.严重腹腔感染患者血清炎性指标表达水平与病情严重程度的相关性分析[J].疑难病杂志,2018,14(6):22-23.
[11]鲍登,常小红,谢加利.降钙素原在呼吸系统疾病诊断中的应用[J].临床肺科杂志,2014,19(1):137-139.
[12]林艳,李微,黄颖璇,等.血清PCT与hs-CRP对新生儿细菌感染性肺炎的诊断价值[J].海南医学,2017,28(10):1627-1628.
[13]徐爽,庄金宝,艾清,等.快速C反应蛋白联合血常规检测提高儿童上呼吸道感染诊断的临床价值[J].中国实验诊断学,2013,17(8):1474-1475.
[14]鲁红春.匹多莫德联合常规药物治疗对反复呼吸道感染儿童感染状态、免疫功能的影响[J].海南医学院学报,2017,23(19):14-15.
[15]郝丽.新生儿细菌性肺炎和轮状病毒感染T淋巴细胞亚群及细胞因子变化分析[D].合肥:安徽医科大学,2014.