免疫球蛋白联合头孢吡肟治疗新生儿感染性肺炎的临床研究

Clinical study on immunoglobulin combined with cefepxime in treatment of neonatal infectious pneumonia

目的探讨静注人免疫球蛋白(pH4)联合注射用盐酸头孢吡肟治疗新生儿感染性肺炎的临床疗效。方法选取2017年10月-2019年1月天津市宝坻区人民医院收治的120例新生儿感染性肺炎患儿作为研究对象,随机将患者分为对照组和治疗组,每组各60例。对照组患儿静脉滴注头孢吡肟注射液60 mg/(kg·d),分两次给药。治疗组在对照组基础上给予静注人免疫球蛋白(pH4)400mg/kg,1次/d。两组患者治疗7~14d。观察两组的临床疗效,比较两组的临床症状、血气指标、免疫球蛋白、炎性因子。结果治疗后,对照组和治疗组的总有效率分别为81.7%、96.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组退热时间、肺部湿啰音消失时间、咳嗽消失时间、住院时间均明显短于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组动脉氧分压(p O2)水平显著升高,二氧化碳分压(pCO2)水平显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组血气指标水平明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组免疫球蛋白水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组炎性因子水平明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论静注人免疫球蛋白(pH4)联合注射用盐酸头孢吡肟治疗新生儿感染性肺炎具有较好的临床疗效,能改善患儿临床症状,增强机体免疫力,降低血清炎性因子,具有一定的临床推广应用价值。

Objective To investigate the effect of Human Immunoglobulin(pH4) for intravenous injection combined with Cefepime Hydrochloride for injection in treatment of neonatal infectious pneumonia. Methods Patients(120 cases) with neonatal infectious pneumonia in Tianjin Baodi District People’s Hospital from January 2017 to January 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Children in the control group were iv administered with Cefepime Hydrochloride for injection 60 mg/(kg·d), divided into two doses. Children in the treatment group were given Human Immunoglobulin(pH4) for intravenous injection 400 mg/kg on the basis of the control group, once daily. Children` in two groups were treated for 7 - 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptoms, blood gas indexes, immunoglobulin, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.7% and 96.7%, respectively, and there was difference between two groups(P < 0.05). After treatment, antipyretic time, lung moist rale disappearance time, cough disappearance time, and hospitalization time in the treatment group were significantly shorter than those in the control group, and there was difference between two groups(P < 0.05). After treatment, the levels of p O2 in two groups were significantly increased, but the levels of p CO2 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the blood gas indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of IgG, IgA and IgM in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the immunoglobulins in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of CRP, IL-6, and PCT in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the inflammatory factors levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Human Immunoglobulin(p H4) for intravenous injection combined with Cefepime Hydrochloride for injection has clinical curative effect in treatment of neonatal infectious pneumonia, can improve clinical symptoms, enhance immunity, and reduce serum inflammatory factors in children, which has a certain clinical application value.