人免疫球蛋白联合拉氧头孢钠治疗新生儿感染性肺炎的临床研究

Clinical study on lyophilized human immunoglobulin combined with latamoxef sodium in treatment of neonatal infectious pneumonia

目的探讨人免疫球蛋白联合拉氧头孢钠治疗新生儿感染性肺炎的疗效观察。方法选取2019年11月-2020年12月南阳市中心医院收治的170例新生儿感染性肺炎患儿,随机分为对照组和治疗组,每组各85例。对照组患儿静脉滴注注射用拉氧头孢钠,每天30 mg/kg,间隔12 h滴注1次,1次滴注30 min以上。治疗组在对照组基础上静脉滴注冻干静注人免疫球蛋白(pH 4),首次剂量400 mg/kg,1次/d。两组患儿均治疗5 d。观察两组患者临床疗效,比较治疗前后两组患者临床症状好转时间、免疫能力,及血清炎症因子超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素6(IL-6)和IL-10水平。结果治疗后,治疗组临床有效率为96.47%,明显高于对照组的87.06%(P<0.05)。治疗后,治疗组临床症状好转时间明显短于对照组(P<0.05)。治疗后,两组免疫球蛋白G(IgG)、IgG1、IgG2、IgG3和IgG4水平升高(P<0.05),且治疗组明显高于对照组(P<0.05)。治疗后,两组hs-CRP、PCT、IL-6和IL-10水平显著降低(P<0.05),且治疗组低于对照组(P<0.05)。结论冻干静注人免疫球蛋白联合抗生素拉氧头孢钠治疗新生儿感染性肺炎疗效显著,能够迅速改善患儿体征和临床症状,增强免疫功能,降低炎症水平。

Objective To investigate the effect of lyophilized human immunoglobulin combined with latamoxef sodium in treatment of neonatal infectious pneumonia. Methods Children(170 cases) with infectious pneumonia in Nanyang Central Hospital from November 2019 to December 2020 were randomly divided into control and treatment groups, and each group had 85 cases. Children in the control group were iv administered with Latamoxef Sodium for injection, 30 mg/kg daily, once at intervals of 12 h, more than 30 min at a time. Children in the treatment group were iv administered with Human Immunoglobulin(pH4) for Intravenous Injection, the first dose was 400 mg/kg, once daily. Children in two groups were treated for 5 d. After treatment, the clinical efficacy was evaluated,the improvement time of clinical symptoms, the immune ability, and the serum inflammatory factors of hs-CRP, PCT, IL-6 and IL-10 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 96.47%, which was significantly higher than 87.06% in the control group(P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the levels of immunoglobulin G(IgG), IgG1, IgG2, IgG3 and IgG4 in both groups were increased(P < 0.05), and those in treatment group were significantly higher than those in control group(P < 0.05). After treatment, the levels of HS-CRP, PCT, IL-6 and IL-10 in both groups were significantly decreased(P < 0.05), and those in treatment group were lower than those in control group(P < 0.05). Conclusion Lyophilized human immunoglobulin combined with latamoxef sodium is effective in treatment of neonatal infectious pneumonia can quickly improve the physical signs and clinical symptoms, enhance the immune function and reduce the level of inflammation.