支气管哮喘合并感染性肺炎患儿对血小板指标、炎性因子水平及Th1/Th2比值的影响观察

Observation of the effects of the levels of platelet and inflammatory factors and Th1/Th2 ratio in children with bronchial asthma complicated with infectious pneumonia

目的探讨支气管哮喘合并感染性肺炎患儿对血小板指标、炎性因子水平及Th1/Th2比值的影响,以期为临床提供指导意见。方法选择2014年1月-2015年12月医院住院支气管哮喘合并感染性肺炎患儿74例为观察组,同期住院支气管哮喘急性发作期患儿63例定为对照1组,同期感染性肺炎患儿80例定为对照2组,3组患儿均给予常规及对症治疗,观察3组患儿治疗情况及治疗前后各项指标水平变化。结果经7d治疗,观察组以总有效率89.19%低于对照1、2组98.41%、97.50%(P<0.05),3组治疗前后各项观察指标对比,差异均有统计学意义(P<0.05),观察组治疗前后PLT、PDW、TNF-α、IL-6、Th1细胞、Th2细胞均高于对照1、2组同期(P<0.05),治疗前后MPV、IL-12、Th1/Th2比值低于对照1、2组同期(P<0.05)。结论支气管哮喘合并感染性肺炎与血小板指标、炎性因子水平及Th1/Th2比值关系密切,常规治疗可改善免疫状态、血小板指标及炎性因子,但疗效并不满意;治疗过程中,如注重检测或改善此指标,有可能成为指导治疗预测预后新指标,也有可能改善治疗效果及结局。

OBJECTIVE To investigate the effects of the levels of platelet and inflammatory factors and Th1/Th2 ratio in children with bronchial asthma complicated with infectious pneumonia,so as to provide guidance for clinical treatment.METHODS A total of 74 cases of patients with bronchial asthma complicated with infectious pneumonia in the hospital from Jan.2014 to Dec.2015 were selected as observation group,63 cases of children with acute bronchial asthma were set as control group 1,and in 80 cases of children with infectious pneumonia at the same period were set as control group 2.The patients of the three groups were given routine and symptomatic treatment,and the changes of indicators levels of the three groups before and after treatment and treatment of children were observed.RESULTS After 7-day treatment,the total efficiency rate of observation group was 89.19%,which was lower than 98.41% and 97.50% of control group 1and control group 2（P〈0.05）,the observation indexes before and after the treatment of the three groups had significant differences（P〈0.05）,the PLT,PDW,TNF-α,IL-6,Th1 cells,and Th2 cells of observation group before and after treatment were all higher than those of control group 1and control group 2at the same period（P〈0.05）,and MPV,IL-12 and the ratio of Th1/Th2 were lower than those of control group 1and control group 2at the same period（P〈0.05）.CONCLUSIONPlatelet index,inflammatory factors and Th1/Th2 ratio were closely correlated with bronchial asthma complicated with infectious pneumonia.The results of routine treatment can improve the immune status,platelet index and inflammatory factors,but the effect is not satisfied.In the treatment process,paying more attention to the detection or improvement of these indexes may be the new indicators to guide the prognosis,and also be possible to improve the treatment effect and outcome.