静脉用丙种球蛋白辅助治疗儿童重症腺病毒肺炎回顾性分析

Intravenous immunoglobulin in the treatment of severe adenovirus pneumonia in children:a clinical observation of 210 cases

目的：观察静脉用丙种球蛋白（IVIG）治疗儿童重症腺病毒肺炎（SAP）的临床疗效和并发症。方法回顾性分析2009年6月至2011年6月210例住院SAP患儿的临床资料，根据是否曾应用IVIG治疗分为IVIG组（109例）和对照组（101例），比较两组的疗效、持续发热时间、住院时间、机械通气时间及并发症比例等。结果两组患儿在入院时病情严重程度及基础疾病比例差异无统计学意义（P均〉0.05）；均给予抗病毒、抗细菌等综合对症支持治疗；IVIG组应用IVIG 250-400 mg/（kg·d），持续3-5 d。IVIG组平均持续发热时间及住院时间，以及部分患儿机械通气时间均比对照组缩短；并发胸腔积液、肺不张、心肌炎、中毒性脑病的比例较对照组减少；有效率高于对照组，差异均有统计学意义（P均〈0.05）。IVIG组患儿在应用IVIG过程中未出现明显不良反应。结论 IVIG辅助治疗儿童SAP有效且安全。

Objective To observe the clinical effect and complications of intravenous immunoglobulin（IVIG）in the treatment of severe adenovirus pneumonia（SAP）in children. Methods Clinical data of 210 hospitalized children with SAP from June 2009 to June 2011 were retrospectively analyzed. Patients were divided into IVIG group （109 cases） and control group （101 cases） to compare the therapeutic effects, duration of fever, length of stay in hospital, duration of mechanical ventila-tion, and complications between the two groups. Results There was no difference in the severity of illness on admission and un-derlying diseases between the two groups. Both groups were given antiviral, antibacterial and comprehensive supporting thera-py, and in the IVIG group IVIG 250-400mg/（kg.d） were administered for 3-5 d. The mean hospital stay and fever time of the IVIG group were significantly shortened comparing to that of the control group, and the time of mechanical ventilation on the IVIG group is less than that of the non-IVIG group. Incidence rate of pleural effusion, atelectas is, myocarditis and toxic enceph-alopathy in the IVIG group is lower than the control group, and the cure rateand effective therapy of the IVIG group is higher than control group, all of the difference was statistically significant （P〈0.05）. No adverse drug reaction was observed. Conclu-sions IVIG is safe and effective in the treatment of SAP in children.