纤维支气管镜肺泡灌洗联合阿奇霉素对支原体肺炎患儿免疫功能,血清MCP-4、MAPK和CysLTR1水平的影响

Effects of Fiberoptic Bronchoalveolar Lavage Combined with Azithromycin on Immune Function,Serum MCP-4,MAPK and CysLTR1 in Children with Mycoplasma Pneumoniae Pneumonia

目的:探讨纤维支气管镜肺泡灌洗联合阿奇霉素对支原体肺炎患儿的治疗效果。方法:选取2019年10月至2021年10月南充市中心医院收治的130例支原体肺炎患儿,以随机数字表法分为观察组、对照组,每组65例。对照组患儿采用阿奇霉素治疗,观察组患儿采用纤维支气管镜肺泡灌洗联合阿奇霉素治疗。综合评估两组患儿的临床疗效、治疗费用、肺通气功能指标[潮气量(TV)、肺活量(VC)、肺总量(TLC)和最大呼气流量(MEF)]、炎症因子[单核细胞趋化蛋白4(MCP-4)、丝裂原活化蛋白激酶(MAPK)和半胱氨酸白三烯受体1(CysLTR1)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+))、治疗安全性等指标水平。结果:观察组患儿的总有效率为92.31%(60/65),高于对照组(78.46%,51/65),差异有统计学意义(P<0.05);观察组患儿的治疗费用低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患儿的TV、VC、TLC和MEF水平均高于对照组,MCP-4、MAPK和CysLTR1水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患儿的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05)。治疗期间,观察组、对照组患儿的不良反应发生率为12.31%(8/65)、9.23%(6/65),两组的差异无统计学意义(P>0.05)。结论:纤维支气管镜肺泡灌洗联合阿奇霉素对支原体肺炎患儿的治疗效果显著,能够改善患儿的肺通气功能,抑制机体的炎症反应,提高机体的免疫功能,不良反应较轻。

OBJECTIVE:To probe into the treatment efficacy of fiberoptic bronchoalveolar lavage combined with azithromycin in children with Mycoplasma pneumoniae pneumonia.METHODS:A total of 130 children with M.pneumoniae pneumonia admitted into Nanchong Central Hospital from Oct.2019 to Oct.2021 were selected to be divided into the observation group and the control group via the random number table,with 65 cases in each group.The control group was treated with azithromycin,while the observation group received fiberoptic bronchoalveolar lavage combined with azithromycin.The clinical efficacy,treatment cost,pulmonary ventilation function indicators[tidal volume(TV),vital capacity(VC),total lung capacity(TLC)and maximal expiratory flow(MEF)],inflammatory factors[monocyte chemoattractant protein 4(McP-4),mitogen-activated protein kinase(MAPK)and cysteine leukotriene receptor 1(CysLTR1)],immune function indicators(CD3,CD4,CD8and CD4/CD8),treatment safety and other indicators were comprehensively evaluated in two groups.RESULTS:The total effective rate in the observation group was 92.31%(60/65),higher than 78.46%(51/65)in the control group,with statistically significant difference(P<0.05).The treatment cost of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of TV,VC,TLC and MEF in the observation group were higher than those in the control group,and the levels of MCP-4,MAPK and CysLTR1 were lower than those in the control group,with statistically significant difference(P<0.05).After treatment,the levels of CD3,CD4and CD4/CD8in the observation group were higher than those in the control group,and the level of CD8was lower than that in the control group,with statistically significant difference(P<0.05).During the treatment,the incidence of adverse drug reactions in the observation group and the control group was respectively 12.31%(8/65)and 9.23%(6/65),and there was no significant difference between two groups(P>0.05).CONCLUSIONS:The treatment efficacy of fiberoptic bronchoalveolar lavage combined with azithromycin in the treatment of M.pneumoniae pneumonia is significant,which can improve the pulmonary ventilation function of children,inhibit the inflammatory response and improve the immune function with mild adverse drug reactions.