地塞米松对大叶性肺炎患儿体征消失时间及血清炎症因子水平的影响

The Effect of Dexamethasone on the Disappearance Time of Physical Signs and the Levels of Serum Inflammatory Factors in Children with Lobar Pneumonia

目的:探讨糖皮质激素对大叶性肺炎患儿体征消失时间及血清炎症因子水平的影响,为临床治疗大叶性肺炎患儿提供指导。方法:选取2018年3月~2020年3月某院诊治的78例大叶性肺炎患儿,依据随机双盲法分为对照组和研究组各39例,对照组应用阿奇霉素联合哌拉西林钠他唑巴坦钠治疗,在此基础上,研究组加用地塞米松治疗,均治疗2周。对比两组体征消失时间、治疗前后炎症指标[C-反应蛋白(CRP)、人血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)、血沉(ESR)]水平、治疗期间不良反应发生情况。结果:治疗2周后,研究组的退烧时间、肺部阴影消退、肺啰音消退及喘咳消退时间均早于对照组(P<0.05);治疗2周后,两组的炎症指标SAA、IL-6、ESR、CRP水平均有所降低,且研究组降幅较大(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:应用地塞米松治疗大叶性肺炎患儿可明显使其临床症状加快消失,使炎症水平有效减轻,促进患儿康复,且安全性较高。

Objective:To investigate the effect of glucocorticoids on the disappearance time of physical signs and serum inflammatory factors levels in children with lobar pneumonia,so as to provide guidance for the clinical treatment of children with lobar pneumonia.Methods:A total of 78 children with lobar pneumonia diagnosed and treated in a hospital from March 2018 to March 2020 were selected and divided into two groups according to the random double-blind method,with 39 cases in each group.The control group was treated with azithromycin combined with piperacillin sodium and tazobactam sodium.On this basis,the study group was treated with dexamethasone for 2 weeks.The disappearance time of physical signs,the levels of inflammatory factors[C-reactive protein(CRP),human serum amyloid A(SAA),interleukin-6(IL-6),erythrocyte sedimentation rate(ESR)]before and after treatment,and the incidence of adverse reactions during the treatment were compared between the two groups.Results:After 2 weeks of treatment,the time of fever regression,lung shadow regression,lung rale regression and asthma regression in the study group were earlier than those in the control group(P<0.05).After 2 weeks of treatment,the levels of SAA,IL-6,ESR and CRP in the two groups decreased,and the decreasing amplitude in the study group was larger(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of dexamethasone in the treatment of children with lobar pneumonia can significantly accelerate the disappearance of clinical symptoms and effectively reduce the levels of inflammation,promote the recovery of the children,with higher safety.