支气管镜联合药物治疗对支原体感染大叶性肺炎患儿疗效及血清IL-17和25(OH)D_(3)水平的影响

Effects of Bronchoscopy on the Efficacy and Levels of Serum IL-17 and 25(OH)D_(3) in Children with Mycoplasma Infection Associated Lobar Pneumonia

目的:探究并分析支气管镜联合药物治疗对支原体感染大叶性肺炎患儿疗效及血清白介素-17(IL-17)和25羟基维生素D_(3)[25(OH)D_(3)]水平的影响。方法:选取本院自2018年9月~2019年9月收治的支原体感染大叶性肺炎患儿85例为研究对象,采用随机数字表法分为观察组(n=43)和对照组(n=42)。对照组患儿给予常规抗炎、止咳及抗生素治疗,观察组患儿在对照组基础上给予支气管镜联合药物治疗。观察并统计两组患儿一般资料(包括性别、年龄、体重、肺炎分期等)、前后咳嗽症状评分、恢复时间、疗效以及血清IL-17水平、血清25(OH)D_(3)水平。结果:两组患儿性别、年龄、体重、肺炎分期等一般资料比较无统计学差异(P>0.05)。治疗后两组患儿咳嗽症状评分降低(P<0.05);治疗后7、14和21天观察组患儿咳嗽症状评分低于对照组(P<0.05);两组患儿退热时间、胸片恢复时间、住院时间具有统计学差异(P<0.05),且观察组短于对照组(P<0.05);两组患儿疗效比较具有统计学差异(U=11.24,P=0.003),且观察组患儿总有效率高于对照组(χ^(2)=8.34,P=0.012);治疗后两组患儿血清IL-17水平降低(P<0.05),且治疗后7和14天观察组低于对照组(P<0.05);治疗后两组患儿血清25(OH)D_(3)升高(P<0.05),且患儿治疗后7和14天观察组高于对照组(P<0.05)。结论:支气管镜联合药物治疗能有效提高支原体感染大叶性肺炎患儿疗效,并改善血清IL-17和25(OH)D_(3)水平,值得临床推广应用。

Objective:To explore and analyze the effect of bronchoscopy combined with drug treatment on the efficacy and levels of serum IL-17 and 25(OH)D_(3) in children with mycoplasma infection associated lobar pneumonia.Methods:85 children with mycoplasma infection associated lobar pneumonia admitted in our hospital from September 2018 to September 2019 were selected as research subjects,divided into observation group(n=43)and control group(n=42)according to the random number table.Patients in the control group were given routine anti-inflammatory cough and antibiotic treatment,while patients in the observation group were given bronchoscopy treatment on the basis of patients in the control group.The general data(including sex,age,weight,stage of pneumonia,etc.),before and after cough symptom score,recovery time,curative effect,serum IL-17 level and serum 25(OH)D_(3) level were observed and counted.Results:There was no significant difference in gender,age,weight,pneumonia stage and other general information between the two groups(P>0.05).After treatment,the scores of cough symptoms in the two groups were significantly lower(P<0.05),and the scores of cough symptoms in the observation group were significantly lower than those in the control group(P<0.05)on the 7th,14th and 21th day after treatment;the time of fever reduction,chest film recovery and hospitalization in the two groups were significantly different(P<0.05),and the time of fever reduction,chest film recovery and hospitalization in the observation group were significantly shorter than those in the control group(P<0.05).Therapeutic effect between the two groups was statistically different(U=11.24,P=0.003).The total effective rate of the patients in the observation group was significantly higher than that in the control group(χ^(2)=8.34,P=0.012).After treatment,the serum IL-17 level in both groups decreased(P<0.05),and the serum IL-17 level in the observation group was significantly lower than that in the control group(P<0.05)on the 7th and 14th day after treatment.The serum 25(OH)D_(3) of the patients in the two groups significantly increased(P<0.05)after treatment The level of serum 25(OH)D_(3) in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:Bronchoscopy combined with medicine can effectively improve the curative effect of children with mycoplasma infection associated lobar pneumonia,and improve the level of serum IL-17 and 25(OH)D_(3),which is worthy of wide clinical application.