酚妥拉明联合头孢噻肟钠治疗儿童重症肺炎的效果

Effects of phentolamine combined with cefotaxime sodium in the treatment of severe pneumonia in children

目的 研究酚妥拉明联合头孢噻肟钠对重症肺炎患儿的疗效,为临床治疗提供依据。方法 选择重症肺炎患儿135例,用随机数字表法分为对照组(68例)和联合组(67例)。对照组给予头孢噻肟钠治疗,联合组加用酚妥拉明治疗。比较2组患儿的临床疗效、炎症因子水平、血气指标、肺功能指标和免疫功能等。结果 联合组有效率(92.54%)高于对照组(73.53%)(P<0.05)。治疗前2组患儿的炎症因子水平比较差异无统计学意义,治疗后联合组的C反应蛋白(C-reactive protein, CRP)、降钙素原(procalcitonin, PCT)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平低于对照组(P<0.05)。治疗前2组患儿的血气指标水平比较差异无统计学意义,治疗后联合组患儿的动脉二氧化碳分压(partial pressure of carbon dioxide, PaCO_(2))水平低于对照组,动脉血氧分压(partial pressure of oxyge, PaO_(2))和动脉血氧饱和度(arterial oxygen saturation, SaO_(2))水平高于对照组(P<0.05)。治疗前2组患儿的免疫功能指标比较差异无统计学意义,治疗后联合组患儿的CD3+和CD4+水平高于对照组、CD8+水平低于对照组(P<0.05)。治疗前2组患儿的肺功能指标比较差异无统计学意义,治疗后联合组第一秒用力呼气容积(forced expiratory volume in one second, FEV1)、用力肺活量(forced vital capacity, FVC)和最大呼气流速峰值(peak expiratory flow, PEF)水平高于对照组(P<0.05)。治疗前2组患儿的可溶性髓系细胞触发受体-1(soluble myeloid cell trigger receptor-1,sTREM-1)、可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)和单核细胞趋化蛋白1(monocyte chemoattractant protein 1,MCP-1)水平比较差异无统计学意义,治疗后联合组患儿的sTREM-1、sICAM-1和MCP-1水平低于对照组(P<0.05)。结论 酚妥拉明联合头孢噻肟钠可明显提高重症肺炎患儿的临床疗效,改善肺功能和血气指标,提高免疫功能,减轻患儿的炎症反应,降低sTREM-1、sICAM-1和MCP-1水平,值得在临床推广应用。

Objective To study the effect of phentolamine combined with cefotaxime sodium on children with severe pneumonia, so as to provide a basis for clinical treatment.Methods 135 children with severe pneumonia were selected and randomly divided into control group(68 cases) and combined group(67 cases). The control group were treated with cefotaxime sodium, and the combined group were additionally treated with phentolamine. The clinical efficacy, inflammatory factor level, blood gas index, lung function index and immune function of the 2 groups were compared.Results The effective rate of the combined group(92.54%) was higher than that of the control group(73.53%)(P<0.05).There was no significant difference in the levels of inflammatory factors between the 2 groups before treatment. After treatment, the levels of C-reactive protein(CRP), procalcitonin(PCT), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in the combined group was lower than that of the control group(P<0.05).There was no statistically significant difference in blood gas index levels between the 2 groups before treatment. After treatment, the level of partial pressure of carbon dioxide(PaCO_(2)) in the combined group was lower than that in the control group, while the levels of partial pressure of oxygen(PaO_(2)) and arterial oxygen saturation(SaO_(2)) in the combined group were higher than those in the control group(P<0.05). Before treatment, there was no significant difference between the 2 groups in terms of immune function indicators. After treatment, the levels of CD3+and CD4+ in the combined group were higher than those in the control group, while the levels of CD8+ were lower than those in the control group(P<0.05).There was no significant difference in pulmonary function indexes between the 2 groups before treatment. After treatment, the levels of forced expiratory volume in one second(FEV1), forced vital capacity(FVC) and peak expiratory flow(PEF) in the combined group were higher than those in the control group(P<0.05). Before treatment, the levels of soluble myeloid cell trigger receptor-1 (sTREM-1),soluble intercellular adhesion molecule-1(sICAM-1)and monocyte chemoattractant protein 1(MCP-1)in the 2groups had no significant difference.After treatment,the levels of sTREM-1,sICAM-1and MCP-1in the combined group were lower than those in the control group(P <0.05).Conclusion Phentolamine combined with cefotaxime sodium can significantly improve the clinical efficacy of children with severe pneumonia,improve the lung function and blood gas index,improve the immune function,reduce the inflammatory reaction,and reduce the levels of sTREM-1,sICAM-1and MCP-1,which is worthy of clinical promotion.