丙种球蛋白联合抗生素降阶梯治疗在小儿重症肺炎中的应用效果

Application effect of gamma globulin combined with antibiotic de-escalation therapy in pediatric severe pneumonia

目的探讨丙种球蛋白联合抗生素降阶梯治疗在小儿重症肺炎中的应用效果。方法选取2020年6月至2021年6月江西省瑞金市人民医院收治的96例重症肺炎患儿作为研究对象,采用随机数字表法将其分为研究组和参照组,每组48例。参照组在基础对症处理措施基础上采用抗生素降阶梯治疗,研究组则在基础对症处理措施基础上采用丙种球蛋白联合抗生素降阶梯治疗。用药6 d后,比较两组患儿治疗效果,测定比较两组患儿炎症因子超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)以及免疫球蛋白A(IgA)和免疫球蛋白G(IgG)等免疫功能的变化,并比较两组患儿不良反应总发生率。结果研究组治疗总有效率高于参照组,差异有统计学意义(P<0.05)。治疗前,两组患儿的hs-CRP、IL-6、IgA、IgG比较,差异无统计学意义(P>0.05);治疗后,两组患儿的hs-CRP、IL-6均低于治疗前,IgA和IgG则高于治疗前,差异有统计学意义(P<0.05),治疗后,研究组hs-CRP、IL-6均低于参照组,IgA和IgG则高于参照组,差异有统计学意义(P<0.05)。两组患儿的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论小儿重症肺炎采用丙种球蛋白联合抗生素降阶梯治疗,能提升机体的免疫功能,提高临床疗效,促进炎症因子的改善,且安全性佳,应用效果良好。

Objective To analyze the application effect of gamma globulin combined with antibiotic de-escalation therapy in pediatric severe pneumonia.Methods A total of 96 children with severe pneumonia admitted to Ruijin People′s Hospital of Jiangxi Province from June 2020 to June 2021 were selected as the study objects,they were divided into study group and reference group according to random number table method,with 48 cases in each group.The reference group was treated with the antibiotic de-escalation therapy based on the basic symptomatic treatment measures,the study group was treated with gamma globulin combined with antibiotic de-escalation therapy based on the basic symptomatic treatment measures.After 6 d of drug administration,the treatment effect of the two groups were observed and analyzed,and the changes of inflammatory factors and immune function such as hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),immunoglobulin A(IgA)and immunoglobulin G(IgG)were measured in the two groups,and the total incidence of adverse reactions was counted and compared between the two groups.Results The total effective rate of the study group was higher than that of the reference group,the difference was statistically significant(P<0.05).There were no significant differences in hs-CRP,IL-6,IgA and IgG between two groups before treatment(P>0.05).After treatment,the hs-CRP and IL-6 of the two groups were lower than those before treatment,while IgA and IgG were higher than those before treatment,the differences were statistically significant(P<0.05).The hs-CRP and IL-6 of study group were lower than those of the reference group,IgA and IgG were higher than those of the reference group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of severe pneumonia in children with gamma globulin combined with antibiotic de-escalation therapy can improve the immune function of the body,improve the clinical efficacy,and promote the improvement of inflammatory factors.It has good safety and application effect.