免疫血清球蛋白联合更昔洛韦对112例RSV引起肺炎患儿肺功能的改善情况

Effect of immune serum globulin combined with ganciclovir on lung function of children pneumonia caused by respiratory syncytial virus

目的:探讨免疫血清球蛋白联合更昔洛韦对呼吸道合胞病毒(RSV)引起肺炎患儿肺功能的改善情况。方法:将112例RSV患儿随机分为对照组和观察组,每组各56例,对照组给予更昔洛韦加综合对症治疗,观察组在对照组基础上加用免疫血清球蛋白,记录和比较两组患者肺功能指标、炎性因子和T细胞亚群水平变化及病毒转阴率和不良反应情况等。结果:观察组呼吸频率(RR)、每公斤潮气量(VT)、达峰容积比(VPTEF/VE)和达峰时间比(TPTEF/TE)改善程度均显著优于对照组(P<0.05);观察组RSV-DNA和RSV-IgM转阴率分别为80.36%和71.43%,显著高于对照组(44.62%、50.00%)(P<0.05);观察组治疗后CD3+、CD4+水平显著高于治疗前和对照组治疗后水平(P<0.05),而CD8+显著低于治疗前和对照组治疗后水平(P<0.05);观察组白介素-1(IL-1)和肿瘤坏死因子-a(TNF-α)水平显著低于对照组(P<0.05)。结论 :免疫血清球蛋白能有效增强更昔洛韦对RSV肺炎患儿的免疫力,促进炎性水平降低,提高病毒清除能力,改善患儿呼吸功能,疗效优于单用更昔洛韦。

Objective：To investigate effect of immune serum globulin combined with ganciclovir on lung function of children pneumonia caused by respiratory syncytial virus（RSV）.Methods：A total of 112 pneumonia children caused by RSV were randomly divided into the control groups and the observation groups,with 56 cases in each group.The control groups were given with comprehensive symptomatic treatment combined with ganciclovir while the observation groups were treated with immune serum globulin based treatment of control groups.The levels of lung function,inflammatory factor and T cell subsets and the virus clearance rate of two groups were record and compared.Results：The improvement of RR,VT,VPEF/VE and TPTEF/TE in the observation group were significantly better than that of the control groups（P〈0.05）.The negative rate of RSV-DNA and RSV-IgM in the observation groups were significantly higher than that of the control groups（P〈0.05）.The levels of CD3＋,CD4＋in the observation groups after treatment were significantly higher than that of the before treatment and the control groups after treatment（P〈0.05）while the CD8＋was significantly lower than that before treatment and the control group after treatment（P〈0.05）.The level of IL-1and TNF-αin observation groups were significantly lower than those of in the control group（P〈0.05）.Conclusions：The immune serum globulin could effectively enhance the immunity of ganciclovir RSV pneumonia,reduce the inflammatory level,enhance viral clearance ability,and improve respiratory function.The curative effect is better than that of single use of ganciclovir.