锌对婴幼儿肺炎患儿的辅助治疗作用及其对体液免疫功能的影响

The Auxiliary Therapy Effect of Zinc on Infants with Pneumonia and Its Effect on Humoral Immune Function

目的探讨锌对婴幼儿肺炎患儿的辅助治疗作用及其对体液免疫功能的影响。方法随机选择同时期在该院儿童保健科进行健康体检的健康婴幼儿60例作为对照组;将120例肺炎患儿随机分为常规治疗组和锌辅助治疗组,锌辅助治疗组在常规治疗基础上于入院后第2天加用锌制剂（6个月内婴儿,10 mg/d;6个月-3岁患儿,20 mg/d;均分2次口服）,连服7 d,常规治疗组仅采用常规治疗。观察两组肺炎患儿的疗效和平均住院日。两组肺炎患儿均于入院后第1天及第8天时采集血液标本,同时采集对照组血液标本,检测各组中血清锌水平和免疫球蛋白（IgA、IgM、IgG）水平,并进行比较。结果锌辅助治疗组的疗效优于常规治疗组（P〈0.05）,锌辅助治疗组患儿的平均住院日低于常规治疗组（P〈0.05）;两组肺炎患儿血清中锌、IgA和IgM水平明显低于对照组（P〈0.05）,而IgG水平无明显变化（P〉0.05）;锌辅助治疗后,血清中IgG、IgA、IgM水平均明显增高（P〈0.05）,血清锌水平与血清中IgA、IgG、IgM水平均呈正相关（P〈0.01）。结论婴幼儿肺炎的发病率与锌缺乏和体液免疫功能降低有关,补锌可以使血清中IgG、IgA、IgM水平增高,从而提高肺炎的疗效和降低患儿平均住院日。

Objective To investigate the auxiliary therapy effect of zinc on infants with pneumonia and its effect on humoral immune function. Methods 60 cases of healthy infants underwent health examination in Department of Child Health Care of our hospital during the same period were randomly selected as the control group. 120 cases of children with pneumonia were randomly divided into conventional treatment group and zinc adjuvant therapy group. Zinc adjuvant therapy group was given zinc preparations on the basis of conventional therapy at the second day after the admission（babies aged within 6 months, 10mg every day; children aged 6 months to 3 years, 20mg per day; all taking orally twice a day）, for 7 days, and the conventional treatment group was only given conventional treatment. The curative effect and the average hospitalization days of the two groups of children with pneumonia were observed. The blood specimens of two groups of children with pneumonia were collected at the first day and eighth day after the admission, and the blood specimens of the control group were also collected. The serum zinc level and immunoglobulin（IgA,IgM, IgG） level of all the groups were detected and compared. Results The curative effect of zinc adjuvant therapy group was better than that of the conventional treatment group（P〈0.05）; the average hospitalization days of zinc adjuvant therapy group were less than those of the conventional treatment group（P〈0.05）. The levels of zinc, IgA and IgM in serum of two groups of children with pneumonia were lower than those of the control group（P〈0.05）, while no significant changes in IgG levels（P〉0.05）. After zinc adjuvant therapy, the levels of zinc, IgA and IgM in serum significantly increased compared with those before treatment（P〈0.05）; the level of zinc was positively correlated with the level of IgA, IgG and IgM in serum（P〈0.01）. Conclusion The incidence of infant pneumonia is related with zinc deficiency and reduction in humoral immune function. Zinc supplementation can increase the level of IgG, IgA and IgM in serum, thereby improving the curative effect of pneumonia and shortening the average days of hospitalization of the children.