谷氨酰胺治疗儿童难治性支原体肺炎临床疗效分析

Analysis of clinical efficacy of glutamine in treating refractory Mycoplasma Pneumoniae pneumonia in children

目的通过比较血清IL-6、IL-8、LDH及铁蛋白水平,观察纤维支气管镜下支气管黏膜损伤修复时间,分析谷氨酰胺对儿童难治性支原体肺炎的免疫调节作用及临床疗效。方法回顾性分析近2年收治的67例难治性支原体肺炎患儿病历资料,将其中应用阿奇霉素、大剂量甲泼尼龙冲击及布地奈德雾化平喘常规治疗者共36例设定为对照组,除上述治疗外联合应用谷氨酰胺颗粒治疗者31例为治疗组,分析比较两组患儿治疗前后血清IL-6、IL-8、LDH、铁蛋白水平变化及纤维支气管镜下改变。结果两组患儿治疗前血清IL6、IL8、LDH及铁蛋白水平比较无差异;治疗7天两组患儿血清IL-6、IL-8、LDH、铁蛋白水平比较差异均有统计学意义(P<0.05),治疗组各测定值水平较对照组明显减低,与治疗前比较差异均有统计学意义(P<0.05);治疗7天纤维支气管镜下观察支气管粘膜损伤修复,治疗组修复率74.2%,对照组修复率52.8%。结论联合应用谷氨酰胺颗粒治疗难治性支原体肺炎可加速降低血清IL-6、IL-8、LDH、铁蛋白水平,促进支气管粘膜损伤修复,缩短病程,改善预后。

Objective Through the comparison of serum IL6,IL8,LDH and Ferritin levels,to observe the fiberoptic bronchoscopy with bronchial mucosal injury repair time,analysis of glutamine on children refractory mycoplasma pneumonia immunomodulatory effects and clinical efficacy. Methods A retrospective analysis of 67 cases refractory mycoplasma pneumonia in children with medical records nearly 2 a,the applying of azithromycin,large doses of armor prednisolone and budesonide atomization and asthma set the routine treatment,a total of 36 cases as control group,except for the combined use of glutamine granules therapy treatment of 31 cases for treatment group,compared serum IL6,IL8,LDH,Ferritin level in two groups of patients before and after treatment and change under fiberoptic bronchoscop.Results There was no difference in serum IL6,IL8,LDH and Ferritin levels in the two groups. Treatment of two groups of children with 7 days,the serum IL6,IL8,LDH,Ferritin level between two groups comparative differences are statistically significant（ P〈 0. 05）,treatment group each measured value level was significantly reduced; Compared with before treatment differences were statistically significant（ P〈 0. 05）; The repair rate of the treatment group was 74. 2%,and the repair rate of the control group was 52. 8%. Conclusion Combined use of glutamine granules treatment refractory mycoplasma pneumonia can reduce serum IL6,IL8,LDH,ferritin level acceleration,promote restoration of the bronchial mucosa damage,shorten the course of the disease and improve prognosis.