万古霉素治疗小儿败血症的疗效及对患儿免疫功能的影响

Efficacy of Vancomycin in Treatment of Septicemia in Children and its Effects on Immunologic Function

目的:探讨万古霉素治疗小儿败血症的疗效及对患儿免疫功能的影响。方法:回顾性选取2016年7月至2017年12月湛江中心人民医院收治的败血症患儿84例,按照治疗方案分为观察组和对照组,每组42例。观察组患儿采用万古霉素治疗,对照组患儿采用头孢呋辛治疗。对比两组患儿的临床疗效、免疫功能[可溶性白细胞介素2受体(s IL-2R)、免疫球蛋白G(IgG)]、降钙素原(PCT)水平、小儿危重病例评分(pediatric critical illness score,PCIS)及不良反应发生情况。结果:观察组患儿的总有效率为95.24%(40/42),明显高于对照组的78.57%(33/42),差异有统计学意义(P<0.05);治疗5 d后,观察组患儿s IL-2R、IgG及PCT水平,PCIS评分明显优于对照组,差异均有统计学意义(P<0.05);观察组、对照组患儿不良反应发生率分别为19.05%(8/42)、11.90%(5/42),差异无统计学意义(P>0.05)。结论:万古霉素治疗小儿败血症的疗效显著,可促进患儿免疫功能及生理机能恢复,有利于患儿预后。

OBJECTIVE： To probe into the efficacy of vancomycin in treatment of septicemia in children and its effects on immune function. METHODS： 84 child patients with septicemia admitted into Zhanjiang Central People＇s Hospital from Jul. 2016 to Dec. 2017 were retrospectively selected and divided into observation group and control group according to different therapeutic regimens, with 42 cases in each. The observation groups was given vancomycin,while the control group was treated with cefuroxime. Differences in clinical efficacy,immunologic function [soluble interleukin-2 receptor（ s IL-2 R） and immune globulin G（ IgG） ],procalcitonin（ PCT） levels,pediatric critical illness scores（ PCIS） and incidences of adverse drug reactions between two groups were compared.RESULTS： The total effective rate of observation group was 95. 24%（ 40/42）,which was significantly higher than that of the control group（ 78. 57%,33/42）,with statistically significant differences（ P〈0. 05）; after 5-day treatment,the s IL-2 R,IgG,PCT levels and PCIS scores of observation group were significantly better than those of the control group,with statistically significant differences（ P〈0. 05）; the incidences of adverse drug reactions of observation group and control group were respectively 19. 05%（ 8/42） and 11. 90%（ 5/42）,the difference had no statistical significance（ P〉0. 05）. CONCLUSIONS： The efficacy of vancomycin in treatment of septicemia in children is remarkable,which can promote the recovery of patients＇ immunologic function and physiological function,that is also beneficial to patients＇ prognoses