丙种球蛋白联合美罗培南治疗小儿败血症的效果及对患儿血清炎性因子、IgG、IgM的影响

Effect of Gamma Globulin Combined with Meropenem in the Treatment of Pediatric Sepsis and Its Influence on Serum Inflammatory Factors,IgG and IgM

目的:研究丙种球蛋白联合美罗培南治疗小儿败血症的效果及对患儿血清炎性因子、IgG、IgM的影响。方法:选取2017年3月-2018年9月本院接诊败血症患儿96例纳入研究,依据随机数法分对照组、干预组,各48例。两组入院后均给予纠正水电解质紊乱、营养支持及改善微循环等常规治疗,同时对照组辅以丙种球蛋白治疗,而干预组在对照组基础上加用美罗培南。对比两组治疗效果及治疗前后血清炎性因子、免疫功能指标的表达。结果:干预组治疗总有效率为91.7%(44/48),高于对照组的72.9%(35/48),差异有统计学意义(P<0.05);两组治疗后血清降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)表达水平降低,干预组更低,差异有统计学意义(P<0.05)。相较于治疗前,治疗后两组血清免疫球蛋白G(IgG)表达水平升高,干预组高于对照组;两组血清免疫球蛋白M(IgM)表达水平降低,干预组低于对照组,差异有统计学意义(P<0.05)。结论:丙种球蛋白联合美罗培南治疗小儿败血症的效果显著,能缓解临床症状/体征,减少血清炎性因子表达水平,减轻机体炎性反应,调节IgG、IgM表达,改善机体免疫功能,值得临床推广。

Objective:To study the effect of Gamma Globulin combined with Meropenem in the treatment of pediatric sepsis and its influence on serum inflammatory factors,IgG and IgM.Method:A total of 96 children with sepsis admitted to our hospital from March 2017 to September 2018 were enrolled in the study.All the patients were divided into control group and intervention group according to random number method,with 48 cases in each group.After the admission,both groups were given routine treatments such as correcting water and electrolyte disorders,nutritional support,and improving microcirculation.At the same time,the control group received Gamma Globulin therapy,the intervention group was treated with Meropenem on the basis of control group.The therapeutic effects of the two groups and the expression of serum inflammatory factors and immune function indicators before and after treatment were compared.Result:The total effective rate of treatment in the intervention group was 91.7%(44/48),which was higher than 72.9%(35/48)in the control group,the difference was statistically signficant(P<0.05).The levels of serum procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)were decreased in the two groups after treatment,and the intervention group was lower than the control group,the differences were statistically significant(P<0.05).Compared with the pre-treatment,the serum immunoglobulin G(IgG)expression level of the two groups increased after treatment,the intervention group was higher than the control group;the serum immunoglobulin M(IgM)expression level of the two groups was lower,the intervention group was lower than the control group,the differences were statistically significant(P<0.05).Conclusion:Gamma Globulin combined with Meropenem is effective in treating children with sepsis.It can alleviate clinical symptoms/signs,reduce the expression levels of serum inflammatory factors,reduce the body’s inflammatory response,regulate the expression of IgG and IgM,and improve the immune function of the body.It is worthy of clinical promotion.