小剂量多巴胺与多巴酚丁胺联合辅助治疗对重症肺炎患儿血清免疫球蛋白、白介素-4、肿瘤坏死因子水平的影响

Effect of adjuvant therapy using small dose dopamine combined with dobutamine on the levels of serum immunoglobulin,interleukin-4,and tumor necrosis factor in children with severe pneumonia

目的探讨小剂量多巴胺与多巴酚丁胺联合辅助治疗对重症肺炎患儿血清免疫球蛋白(IgE)、白介素-4(IL-4)、肿瘤坏死因子(TNF-α)水平的影响。方法选择2013年7月-2016年7月随州市妇幼保健院收治的92例重症肺炎患儿作为观察对象,通过数字标号双盲法随机分为两组:对照组(46例)针对患儿症状对症处理,及时消炎抗病毒常规用药;观察组(46例)开展常规治疗措施结合小剂量多巴胺与多巴酚丁胺进行辅助用药,观察患儿症状缓解时间、评估用药疗效,检测患儿治疗前与治疗后IgE、IL-4以及TNF-α水平的变化。结果所有患儿治疗后血清IgE、IL-4、TNF-α等水平均明显下降(P<0.05);观察组患儿在治疗第10天血清因子IgE、IL-4、TNF-α等指标改善幅度显著优于对照组(P<0.05);观察组治疗总有效率为93.48%,对照组患儿治疗有效率为80.43%,两组比较,差异有统计学意义(P<0.05)。结论临床治疗小儿重症肺炎采取小剂量多巴胺与多巴酚丁胺联合用药,疗效显著,可在短期内改善患儿血清因子IgE、IL-4、TNF-α水平,调节自身免疫功能,改善心肺功能。

Objective To explore the effect of adjuvant therapy using small dose dopamine combined with dobutamine on the levels of serum immunoglobulin（ IgE）,interleukin-4（ IL-4）,and tumor necrosis factor（ TNF-α） in children with severe pneumonia.Methods Ninety-two children with severe pneumonia treated in Suizhou Municipal Maternal and Child Health Care Hospital from July 2013 to July 2016 were selected and divided into two groups according to digital label double blind method,46 children in control group were treated by routine therapy,including symptomatic treatment,timely anti-inflammation therapy,and antiviral therapy,and 46 children in observation group were treated by routine therapy combined with adjuvant therapy using small dose dopamine combined with dobutamine. The remission time of symptoms was observed,the curative effect was evaluated,the levels of IgE,IL-4,and TNF-α before and after treatment were detected. Results The levels of IgE,IL-4,and TNF-α after treatment decreased significantly compared with before treatment（ P0. 05）. The improvement amplitudes of serum IgE,IL-4,and TNF-α on the tenth day of treatment in observation group were statistically significantly higher than those in control group（ P0. 05）. The total effective rates in observation group and control group were 93. 48% and 80. 43%,respectively,there was statistically significant difference between the two groups（ P0. 05）. Conclusion The clinical effect of small dose dopamine combined with dobutamine in treatment of children with severe pneumonia is significant,the therapy can improve the levels of serum IgE,IL-4,and TNF-α in a short time,regulate immune function,and improve cardiopulmonary function.