重症毛细支气管炎患儿免疫功能检测及免疫球蛋白治疗临床研究

Detection of Immune Function in Children with Severe Bronchiolitis and Clinical Research of Treatment with IVIG

目的:检测重症毛细支气管炎患儿的体液免疫和细胞免疫功能,同时研究免疫球蛋白(IVIG)治疗对患儿临床症状、体征和住院时间的影响。方法:将住院的68例重症毛细支气管炎患儿作为研究对象,设为观察组,同期将在儿童保健门诊体检的60例健康儿童设为对照组,分别对其进行各免疫指标的测定。随后将68例重症毛细支气管患儿随机分为两组,对照组34例用常规方法治疗,IVIG治疗组34例在常规治疗的基础上用400mg/(kg·d)的IVIG连续静滴5天,分别观察两组的喘憋消失时间、肺部体征消失时间和住院天数。结果:重症毛细支气管炎患儿的IgA、IgG、C3均明显低于健康对照组,差异有显著意义,分别为P<0.01和P<0.05;而CD8明显低于健康对照组,CD4/CD8明显高于健康对照组,差异有显著意义(P均<0.01)。重症毛支患儿经IVIG治疗后其喘憋消失时间、肺部体征消失时间和住院天数均明显缩短,差异有显著意义(P<0.01,P<0.05)。结论:重症毛细支气管炎患儿存在明显的体液免疫和细胞免疫功能紊乱,补充IVIG治疗可显著改善患儿的症状和体征,缩短住院时间。

Objective：To detect humoral immunity and cellular immune function of children with severe bronchiolitis, at the same time, clinical symptoms, signs and length of hospital stay were observed after treatment with the immune globulin （IVIG）. Methods： 68 cases of severe bronchiolitis patients in hospital as the research object, as a group, in the same period, in the child care examination clinic , 60 healthy children as control group, the two groups respectively, for the immune index detection. Then 68 cases of severe bronchiolitis were randomly divided into two groups, 34 cases of control group treated with conventional methods, and 34 cases of WIG treatment group treated with IVIG （400 mg/kg）on the basis of conventional treatment and IVIG was dropped for 5 consecutive days, then wheezing disappear time, pul- monary symptoms disappear time and hospitalization days of the two groups were observed respectively. Results： IgA, IgG, C3 of children with severe bronehiolitis were significantly lower than the healthy control group, the differences are significant, （P〈0.01 and P〈0.05 respectively） ~ While CD8 significantly lower than the healthy control group, CD4/CD8 is significantly higher than healthy control group, both have significant differences, （P〈0. 01）. wheezing disappear time, pulmonary symptoms disappear time and hospitalization days of Severe bronchiolitis patients after treatment with IVIG were significantly shortened, they have significant differences, （P〈 0. 0l and P〈 0. 05）. Conclllsion：Children with severe bronchiolitis are of obvious humoral immunity and cellular immune dysfunction, and IVIG treatment can significantly improve the patient＇s signs and symptoms, shorten the hospitalization time.