雾化吸入重组人干扰素α2b联合小剂量甲泼尼龙治疗小儿重症病毒性肺炎疗效分析

Efficacy of Aerosol Inhalation of Recombinant Human Interferon α2b Combined with Low-dose Methylprednisolone in the Treatment of Severe Viral Pneumonia in Children

目的:探讨雾化吸入重组人干扰素α2b联合小剂量甲泼尼龙治疗小儿重症病毒性肺炎疗效和安全性。方法:选择我院儿科2016年9月至2018年11月收治的78例重症病毒性肺炎住院病例,随机分成3组,对照组26例给予基础抗感染治疗联合甲泼尼龙2 mg·kg^(-1)·d^(-1),静滴;治疗组26例在对照组基础上加高剂量干扰素20万IU·kg^(-1)·次^(-1),bid,雾化吸入;观察组26例在治疗组基础上予减甲泼尼龙为1 mg·kg^(-1)·d^(-1),静滴。结果:与对照组比较,治疗组和观察组退热时间、氧饱和度恢复时间、肺部罗音消失时间、住院天数缩短(P<0.05);三凹征消失三组间比较差异无统计学意义(P>0.05)。治疗组和观察组比较,各项观察指标差异无统计学意义(P>0.05)。三组病例间疗效比较,24 h有效率分别为对照组23.1%、治疗组57.7%、观察组53.8%(P<0.05);72 h有效率分别为对照组73.1%、治疗组100%、观察组96.2%(P<0.05);住院7 d治愈率分别为对照组39.5%、治疗组80.8%、观察组73.1%(P<0.05)。结论:雾化吸入高剂量重组人干扰素α2b联合小剂量甲泼尼龙短疗程治疗重症病毒性肺炎取得较好疗效,未见不良反应。二者联用显著缩短热程,肺部啰音消失和病灶吸收快,缩短住院时间,安全性高。

Objective : To investigate the efficacy and safety of aerosol inhalation of recombinant human interferon α2b combined with low dose methylprednisolone in the treatment of severe viral pneumonia in children. Methods :A total of 78 patients with severe viral pneumonia admitted to our hospital from September 2016 to November 2018 were randomly divided into 3 groups.The control group(26 cases)was treated with basic anti-infection therapy combined with methylprednisolone 2 mg·kg^-1 ·d^-1 .The treatment group (26 cases)was treated with a high dose of interferon (200 000 IU·kg^-1 ,bid) on the basis of the control group,atomization inhalation. The observation group(26 cases)was treated with reduced methylprednisolone 1 mg·kg^-1 ·d^-1 . Results :Compared with the control group, the time of fever, recovery of oxygen saturation, disappearance of rales in lung and hospitalization days in the treatment group and the observation group were significantly shorter( P< 0.05), while there was no significant difference between the three concave signs disappearance( P> 0.05). Compared with the observation group, there were no significant differences in all observed indicator of the treatment group( P> 0.05). The effective rate in 24 h was compared among the three groups. For the control group 23.1%, the treatment group 57.7%, the observation group 53.8%( P< 0.05). 72 h effective rate for the control group 73.1%, the treatment group 100%, the observation group 96.2%( P< 0.05). The cure rate was 39.5% in the control group, 80.8% in the treatment group and 73.1% in the observation group( P< 0.05). Conclusion :Nebulization inhalation of high-dose recombinant human interferon α2b combined with low-dose methylprednisolone short course of treatment of severe viral pneumonia has achieved good results, no adverse reactions.The combination of the two drugs significantly shorten the time of fever, pulmonary rales disappear quickly, shorten the hospital stay, and children with good compliance, high safety advantages in children.