地塞米松辅助治疗小儿大叶性肺炎的临床疗效及对炎症因子、血沉的影响

Efficacy of adjuvant therapy with dexamethasone in children with lobar pneumonia and its influence on inflammatory factors and ESR levels

目的小儿大叶性肺炎的病死率较高,因此探索有效的治疗方案十分重要,本研究旨在探讨地塞米松辅助治疗小儿大叶性肺炎的临床疗效及对炎症因子、血沉的影响。方法选取2015年6月—2016年8月于瑞安人民医院进行治疗的大叶性肺炎患儿96例,随机对照表法分为观察组和对照组,各48例。对照组采取抗感染退热、去咳平喘等常规治疗,观察组在对照组的基础上加用地塞米松,剂量为0.2 mg/kg,1次/d,2组患儿均治疗7 d。观察2组临床疗效、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素8(IL-8)及血沉变化情况并进行比较。结果观察组治疗后总有效率为93.75%(45/48),对照组治疗总有效率为70.83%(34/48),观察组治疗总有效率明显高于对照组(χ~2=8.649,P<0.05);观察组临床症状消失时间(包括发热持续时间、咳嗽缓解时间及肺部啰音消失时间)、住院时间均明显少于对照组(t=-7.743、-8.073、-8.241、-4.112,P<0.05);2组治疗后炎症因子TNF-α、IL-6、IL-8及血沉水平均较治疗前显著降低(t_(观察组)=18.552、17.574、15.788、11.718,t_(对照组)=10.500、11.085、11.979、6.315,P<0.05),且观察组降低更显著(t=-13.250、-9.223、-9.161、-7.975,P<0.05)。结论地塞米松辅助治疗小儿大叶性肺炎疗效确切,可明显降低炎症反应及血沉,可明显缓解患者临床症状,缩短住院时间。

Objective The mortality rates are higher in children with lobar pneumonia, and the study on regimen is very important. This study aims to investigate the effect of adjuvant therapy with dexamethasone in children with lobar pneumo- nia, and its influence on the levels of iniqammatory factors and ESR. Methods A total of 96 children with lobar pneumo- nia in our hospital from Jun,2015 to August,2016 were enrolled and divided into observation group（48 cases）and control group （48 eases）. The two groups were given the conventional therapy including anti-inflammatory, cooling, antitussive and relieving asthma,and the observation group was additionally given adjuvant therapy with dexamethasone, with a dose of 0.2 mg/kg,1 time a day. The efficacy,levels of inflammatory faetors and ESR before and after treatment were compared between the two groups. Results Total effective rate of the observation group （93.75%） was significantly higher than eontrol group （ 70.83 % ） after the treatment （ χ^2 = 8. 649, P 〈 0.05 ） ; Clinical symptoms disappearing time and hospitalization time of the observation group was significantly lower than those in control group （t = - 7. 743, - 8. 073, - 8. 241, - 4.112,P 〈 0.05） ;The levels of TNF-α, IL-6, IL-8 and ESR were decreased significantly after the treatment in 2 groups （tobservation group = 18.552,17. 574 ,15. 788 ,11. 718,tcontrol group = 10.500,11.085,11.979,6. 315,P 〈0.05） ,and the obser- vation group deereased more significantly than those in the control group（ t = - 13. 250, -9. 223, -9. 161, -7. 975 ,P 〈 0. 05）. Conclusion Adjuvant therapy with dexamethasone has obvious effect on children with lobar pneumonia, whieh ean obviously improve inflammation and ESR, relieve clinical symptoms, shorten hospitalization time.