甲泼尼龙治疗对RMPP患儿凝血酶调节蛋白、sTREM-1及TNF-α的影响

Effects of methylprednisolone treatment on thromboplastin,sTREM-1 and TNF-α in children with RMPP

目的 探讨甲泼尼龙治疗对难治性肺炎支原体肺炎(RMPP)患儿凝血酶调节蛋白、可溶性髓系细胞触发受体1(sTREM-1)及肿瘤坏死因子-α(TNF-α)的影响。方法 选取2019年1月至2022年1月期间建湖县人民医院收治的RMPP患儿105例,按照患儿监护人选择治疗方案不同分为研究组(甲泼尼龙联合阿奇霉素序贯疗法,n=54)和对照组(阿奇霉素,n=51)。对比两组临床疗效、凝血酶调节蛋白、sTREM-1、炎性因子[白介素-5(IL-5)、TNF-α、C-反应蛋白(CRP)]及不良反应。结果 研究组总有效率(96.30%)明显高于对照组(80.39%),差异有统计学意义(P<0.05)。治疗后,两组凝血酶调节蛋白、sTREM-1水平均下降,且研究组凝血酶调节蛋白、sTREM-1水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组IL-5、TNF-α、CRP水平均下降,且研究组IL-5、TNF-α、CRP水平低于对照组,差异均有统计学意义(P<0.05)。研究组不良反应率为14.84%,对照组不良反应率为7.84%,两组不良反应比较差异无统计学意义(P>0.05)。结论 甲泼尼龙联合阿奇霉素序贯疗法治疗RMPP患儿能有效改善患者凝血酶调节蛋白、sTREM-1水平,减轻炎症反应,安全性可,值得推广应用。

Objective To investigate the effect of methylprednisolone treatment on thromboplastin,soluble myeloid cell trigger receptor 1(sTREM-1)and tumor necrosis factor-α(TNF-α)in children with refractory Mycoplasma pneumoniae pneumonia(RMPP). Methods 105 children with RMPP admitted to Jianhu County People ’ s Hospital from January 2019 to January 2022 were selected,and according to the difference in treatment,they were divided into the study group(methylprednisolone combined with azithromycin sequential,n=54)and the control group(azithromycin,n=51). The clinical efficacy,thrombin regulatory protein,s TREM-1,inflammatory factors and adverse reactions were compared between the two groups. Results The total effective rate in the study group(96.30%)was significantly higher than that in the control group(80.39%),the difference was statistically significant(P<0.05). After treatment,the levels of thrombin regulatory protein and sTREM-1 in the two groups decreased,and the levels of thrombin regulatory protein and s TREM-1 in the study group were lower than those in the control group,the difference was statistically significant(P<0.05). After treatment,the levels of IL-5,TNF-α and C-reactive protein(CRP)in the two groups decreased,and the levels of IL-5,TNF-α and CRP in the study group were lower than those in the control group,the difference was statistically significant(P<0.05). There was no difference in adverse reactions between the two groups(P>0.05). Conclusion The sequential therapy of methylprednisolone combined with azithromycin can effectively improve the levels of thrombin regulatory protein and sTREM-1 in children with RMPP,and reduce the body’s inflammatory response,the safety is acceptable,worthy of clinical application.