激素治疗腺病毒感染脓毒症的临床研究

Clinical Study of Adenovirus Infection Sepsis Hormone Therapy

目的提高腺病毒引起脓毒症的重视,早期激素治疗的临床疗效。方法选取79例2013年6月至2014年12月收治的腺病毒肺炎并脓毒症患儿,随机分组为使用激素治疗组及非激素使用治疗组,每例患儿的血清标本采用间接酶联免疫吸附试验检测ADV-Ig M阳性,均符合全身炎性反应综合征诊断,使用激素治疗组41例,非激素使用治疗组38例,对比两组发热持续时间、肺部症状持续时间、器官功能损害情况、住院时间,并用SPSS17软件进行统计分析。结果 79例均有发热,使用激素治疗组:发热平均持续时间(3.54±1.286)d,咳嗽、有痰持续(5.88±1.873)d,肺部啰音持续(4.32±1.822)d,平均住院天数(6.46±2.05)d,心肌损害8例(19.5%);非激素使用治疗组发热平均持续时间(4.65±1.257)d,咳嗽、有痰持续(7.65±1.76)d,肺部啰音持续(5.24±1.923)d,平均住院天数(6.58±2.677)d,心肌损害9例(23.7%)。结论腺病毒是小儿常见病原体,腺病毒感染引起全身炎性反应综合征是脓毒症的一种,早期诊断并早期使用小剂量激素可抑制炎症,缓解症状,控制病情,治疗及时,减少脏器损害、并发症发生。

Objective Increase attention to sepsis caused by adenovirus, the clinical efficacy of glucocorticoid therapy. Methods Selected 79 cases from June 2013 to December 2014 were treated adenovirus pneumonia and sepsis in children. The children were divided into two groups, randomized to glucocorticoid treatment group and the non-use of glucocorticoid treatment group. Serum samples per children using indirect enzyme-linked immunosorbent assay ADV-Ig M positive, they are in line with the diagnosis of systemic inflammatory response syndrome, glucocorticoid treatment group 41 cases, non-use of glucocorticoid treatment group 38 cases. Comparing two groups of duration of fever, pulmonary symptoms duration, organ dysfunction, length of stay, and statistical analysis software with SPSS17. Results 79 cases had fever, glucocorticoid treatment group the average duration of fever（3.54±1.286） days, cough, phlegm continued（5.88±1.873） days, pulmonary rales continue（4.32±1.822） days, the average length of stay hospital（6.46±2.05） days, myocardial damage 8 cases（19.5%）. Non-use of glucocorticoid treatment group the average duration of fever（4.65±1.257） days, pulmonary rales continue（5.24±1.923） days, cough, phlegm continued（7.65±1.76） days, the average length of stay hospital（6.58±2.677） days, myocardial damage 9 cases（23.7%）. ConclusionAdenoviruses are common pathogens in children, adenovirus infection cause systemic inflammatory response syndrome is one of sepsis. Early diagnosis and early use of low-dose glucocorticoids inhibit inflammation, relieve symptoms, control of the disease, timely treatment reduce organ damage and complications.