糖皮质激素联合纤维支气管镜灌洗治疗大叶性肺炎患儿疗效及对血浆T淋巴细胞免疫球蛋白和炎症因子的影响

Glucocorticoid Combined with Bronchoalveolar Lavage Fluid on Children with Lobar Pneumonia and Its Influences on Plasma T Lymphocytes Immunoglobulins and Inflammatory Factors

目的:探究糖皮质激素联合纤维支气管镜灌洗治疗大叶性肺炎患儿疗效及对血浆T淋巴细胞、免疫球蛋白和炎症因子的影响。方法:选取2018年10月至2019年10月本院收治的大叶性肺炎患儿158例,简单随机分组法分为观察组(n=83)和对照组(n=75)。对照组给予糖皮质激素治疗,观察组给予糖皮质激素联合纤维支气管镜灌洗治疗,比较两组的临床疗效,临床症状改善情况,治疗前后血浆T淋巴细胞、免疫球蛋白和炎症因子水平。结果:观察组患儿的治疗总有效率为92.77%高于对照组的78.67%(P<0.05);观察组的咳嗽缓解时间、高热消退时间、肺部阴影消失时间和肺部啰音消失时间均短于对照组(P<0.05)。治疗后,观察组的CD3+、CD4+水平高于对照组,CD8+水平低于对照组(P<0.05);治疗后,观察组的免疫球蛋白A(IgA)、免疫球蛋白M(IgM)和免疫球蛋白G(IgG)水平高于对照组;治疗后,观察组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平均低于对照组(P<0.05)。结论:糖皮质激素联合纤维支气管镜灌洗在治疗儿童大叶性肺炎方面疗效确切,可有效缓解患儿临床症状,改善患儿免疫功能,减轻机体炎症反应,促进患儿恢复。

Objective:To explore the curative effect of glucocorticoid combined with bronchoalveolar lavage fluid(BALF)on children with lobar pneumonia and its influences on plasma T lymphocytes,immunoglobulins and inflammatory factors.Methods:A total of 158 children with lobar pneumonia who were admitted to the hospital from October 2018 to October 2019 were enrolled and divided into observation group(n=83)and control group(n=75)by simple random grouping method.The control group was treated with glucocorticoid,while observation group was treated with glucocorticoid and BALF.The clinical curative effect,improvement of clinical symptoms and signs,levels of plasma T lymphocytes,immunoglobulins and inflammatory factors before and after treatment were compared between the two groups.Results:The total response rate of treatment in observation group was higher than that in control group(92.77%vs 78.67%)(P<0.05).The relief time of cough,fading time of hyperpyrexia,disappearance time of lung shadows and lung rales in observation group were shorter than those in control group(P<0.05).After treatment,CD3+and CD4+levels in observation group were higher than those in control group,while CD8+level was lower than that in control group(P<0.05).After treatment,levels of immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG)in observation group were higher than those in control group,while levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)were lower than those in control group(P<0.05).Conclusion:The curative effect of glucocorticoid combined with BALF is significant on children with lobar pneumonia,which can effectively relieve clinical symptoms,improve immune function,reduce inflammatory response and promote their recovery.