酚妥拉明联合亚胺培南西司他丁钠对重症肺炎患儿肺功能、炎性因子及血清sTREM-1、sICAM-1水平的影响

Effects of Phentolamine Combined with Imipenem and Cilastatin Sodium on Pulmonary Function,Inflammatory Factors and Serum Levels of sTREM-1 and sICAM-1 in Children with Severe Pneumonia

目的:研究酚妥拉明联合亚胺培南西司他丁钠对重症肺炎患儿肺功能、炎性因子以及血清可溶性髓系细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)水平的影响。方法:选择2018年9月至2019年10月在我院治疗的80例重症肺炎患儿,随机分为对照组(40例)和研究组(40例)。对照组给予静滴亚胺培南西司他丁钠,研究组在对照组基础上静滴酚妥拉明注射液。比较两组患儿临床疗效,对比两组患儿退热时间、肺啰音和咳嗽消失时间及住院时间,比较两组患儿治疗前后肺功能变化情况,测定并比较两组患儿治疗前后血清炎性因子水平变化及血清sTREM-1、sICAM-1水平变化。结果:研究组总有效率(92.50%)明显高于对照组(75.00%),差异具有统计学意义(P<0.05);研究组退热时间、肺啰音及咳嗽消失时间和住院时间与对照组相比,均明显减少(P<0.05);治疗后,研究组的动脉血氧分压(PaO2)和动脉/肺泡氧分压比值(a/APO2)较对照组明显升高,二氧化碳分压(PaO2)较对照组明显降低(P<0.05);治疗后,研究组血清白细胞介素(IL)-6、IL-8和C反应蛋白(CRP)及血清中sTREM-1、sICAM-1水平较对照组显著降低(P<0.05)。结论:酚妥拉明联合亚胺培南西司他丁钠治疗重症肺炎患儿,可以明显提高肺功能,降低炎性因子水平,降低血清中sTREM-1和sICAM-1水平,促进症状好转,提高疗效,减少住院时间。

Objective:To explore the effects of phentolamine combined with imipenem and cilastatin sodium on pulmonary function,inflammatory factors and serum levels of soluble myeloid cell trigger receptor-1(sTREM-1)and soluble intercellular adhesion molecules-1(sICAM-1)in children with severe pneumonia.Methods:80 children with severe pneumonia treated in our hospital from September 2018 to October 2019 were randomly divided into control group(40 cases)and study group(40 cases).The control group was given intravenous infusion of imipenem and cilastatin sodium,the study group was given intravenous infusion of phentolamine injection on the basis of control group.The clinical effect of children in the two groups was compared.The disappearance time of fever,disappearance time of pulmonary rales and coughs as well as hospitalization time were compared.Before and after treatment,the changes of pulmonary function was compared,the changes of serum inflammatory factors levels and sTREM-1 and sICAM-1 levels were observed and compared.Results:The total effective rate in study group(92.5%)was significantly higher than that in control group(75%),the difference was statistically significant(P<0.05).Compared with the control group,the disappearance time of fever,disappearance time of pulmonary rales and coughs as well as hospitalization time in study group was significantly reduced(P<0.05).After treatment,the levels of arterial partial pressure of oxygen(PaO2)and arterial/alveolar oxygen pressure ratio(a/APO2)in the study group were significantly higher than those in the control group,but the level of partial pressure of carbon dioxide(PaO2)was significantly lower than that in the control group(P<0.05).The levels of serum interleukin(IL)-6,IL-8,C-reactive proteins(CRP),sTREM-1 and sICAM-1 in the study group were significantly decreased than those in the control group(P<0.05).Conclusion:Phenolramine combined with imipenem and cilastatin sodium in the treatment of children with severe pneumonia can significantly improve pulmonary function,reduce the levels of inflammatory factors and the serum levels of sTREM-1 and sICAM-1,promote the improvement of symptoms,improve the efficacy and shorten the hospitalization time.