多巴胺、多巴酚丁胺、氨溴索联合佐治小儿重症肺部感染疗效及对免疫、炎性因子水平影响

Efficacy of dopamine,dobutamine,combined with ambroxol hydrochloride in treatment of children with severe pulmonary infections and influence on levels of immunologic and inflammatory factors

目的探讨多巴胺、多巴酚丁胺、氨溴索联合佐治小儿重症肺部感染疗效及对免疫、炎性因子水平影响,为临床治疗提供依据。方法选取2014年1月-2015年12月医院收治小儿重症肺部感染患儿100例,分为2组,对照组44例在常规治疗基础上给予多巴胺、多巴酚丁胺治疗,观察组56例在对照组基础上给予氨溴索治疗;于治疗前、治疗后3、10d抽取空腹肘静脉血5ml送检,观察炎性因子白介素-6(IL-6)、白介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子ɑ(TNF-α),及免疫因子CD_3^+、CD_4^+、CD_8^+变化,于治疗10d后评定治疗效果及不良反应。结果经10d治疗,观察组总有效率98.21%高于对照组(P<0.05);观察组治疗3、10d各项炎性因子均低于同组治疗前及对照组同期(P<0.05);观察组治疗3、10d各项免疫因子均高于同组治疗前及对照组同期(P<0.05)。结论多巴胺、多巴酚丁胺、氨溴索联合佐治小儿重症肺部感染可降低机体炎性因子水平,改善免疫功能,治疗效果满意,值得临床推广。

OBJECTIVE To explore the efficacy of dopamine ,dobutamine ,combined with ambroxol hydrochloride in treatment of children with severe pulmonary infections and observe the influence on levels of immunological and inflammatory factors so as to provide guidance for clinical treatment .METHODS A total of 100 children with severe pulmonary infections who were treated in the hospital from Jan 2014 to Dec 2015 were enrolled in the study and di‐vided into two groups .44 patients were assigned as the control group and were treated with dopamine and dobu‐tamine based on the conventional therapy ,and 56 patients were set as the observation group and were given ambr‐oxol hydrochloride based on the treatment of the control group .5ml of fasting elbow venous blood was extracted and submitted before the treatment and after the treatment for 3 ,10 days .The changes of levels of inflammatory factors interleukin‐6 （IL‐6） ,interleukin‐8 （IL‐8） ,C‐reactive protein （CRP） ,and tumor necrosis factorɑ（TNF‐α） as well as levels of immunologic factors CD3 ＋ ,CD4 ＋ ,and CD8 ＋ were observed;the therapeutic effects and ad‐verse reactions were evaluated after the treatment for 10 days .RESULTS After the treatment for 10 days ,the total effective rate of the observation group was 98 .21% ,higher than that of the control group （P〈0 .05） .The levels of the inflammatory factors of the observation group were lower after the treatment for 3 ,10 days than before the treatment and were lower than those of the control group during the same periods （P〈0 .05） .The levels of the immunologic factors of the observation group were higher after the treatment for 5 ,10 days than before the treat‐ment and were higher than those of the control group during the same periods （P〈0 .05） .CONCLUSION The do‐pamine ,dobutamine ,combined with ambroxol hydrochloride ,as is used for treatment of the children with severe pulmonary infection , can reduce the levels of inflammatory factors , improve the immune function , and achieve satisfied therapeutic effect;it is worthy to be promoted in the hospital .