糖皮质激素联合丙球蛋白治疗儿童麻疹合并细菌性肺炎疗效

Efficacy of glucocorticoids combined with gamma globulin in treatment of children with measles and bacterial pneumonia

目的探究糖皮质激素联合丙球蛋白治疗麻疹合并细菌性肺炎患儿的效果。方法选择2017年7月-2019年12月湖北省中医院收治的麻疹合并细菌性肺炎患儿作为研究对象,采用随机数字表法分为研究组(40例)及对照组(42例)。对照组给予丙种球蛋白治疗,研究组给予甲基强的松龙、丙种球蛋白治疗。于治疗前后进行胸片分级,记录症状缓解时间,测定血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,测定T淋巴细胞亚群比例,评估疗效及安全性。结果研究组整体疗效优于对照组(P=0.041)。研究组治疗后胸片分级优于对照组(P<0.05),退热时间、气促缓解时间、咳嗽缓解时间、肺啰音消失时间、胸片阴影吸收时间均短于对照组(P<0.05)。研究组治疗后血清CRP、TNF-α、IL-6水平均低于对照组(P<0.001)。两组治疗前后T淋巴细胞亚群比例差异均无统计学意义;两组不良反应发生率差异无统计学意义。结论糖皮质激素联合丙种球蛋白可促进麻疹合并肺炎患儿术后恢复,有较好的临床效果。

OBJECTIVE To explore the efficacy of glucocorticoids combined with gamma globulin in the treatment of children with measles and bacterial pneumonia.METHODS Children with measles and bacterial pneumonia admitted to the Hubei Provincial Hospital of Traditional Chinese Medicine between Jul.2017and Dec.2019were selected as the research subjects,and were divided into study group(40cases)and control group(42cases)using a random number table method.The control group were treated with gamma globulin,while the study group were treated with methylprednisolone and gamma globulin.Chest X-ray classification was performed before and after treatment,and the time of symptom relief was recorded.Serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels were measured.The proportions of T-lymphocyte subsets were determined,and the efficacy and safety were evaluated.RESULTS The overall efficacy of the study group was significantly better than that of the control group(P=0.041).After treatment,the classification of Chest radiographs in the study group was significantly better than that of the control group(P<0.05).The fever abatement time,shortness of breath relief time,cough relief time,lung rale disappearing time,and chest X-ray shadow absorption time were all significantly less than those of the control group(P<0.05).After treatment,serum CRP,TNF-αand IL-6levels in the study group were significantly lower than those in the control group(P<0.05).There were no significant differences in the proportions of T lymphocyte subsets between the two groups before and after treatment,the difference in the incidence of adverse reactions between the two groups was not significant(P>0.05).CONCLUSION Glucocorticoids combined with gamma globulin can promote the recovery of children with measles and bacterial pneumonia,with good clinical effects.