人免疫球蛋白辅助治疗肺炎支原体肺炎合并中枢神经系统损伤患儿的效果

Effect of Human Immunoglobulin Adjuvant Therapy in Children with Mycoplasma Pneumoniae Pneumonia Complicated with Central Nervous System Damage

目的:探讨人免疫球蛋白(Ig)辅助治疗肺炎支原体肺炎(MPP)合并中枢神经系统损伤(CNSD)患儿的效果。方法:纳入平南县人民医院2021年8月—2022年6月收治的70例MPP合并CNSD患儿,按随机数表法分为阿奇霉素组和Ig辅助组,各35例。所有患儿接受常规对症支持治疗,阿奇霉素组给予口服阿奇霉素,Ig辅助组在阿奇霉素组基础上给予人Ig辅助治疗。对比两组的疗效、脑脊液白细胞水平、血清炎症因子水平、血气分析、肺功能、不良反应。结果:治疗后,Ig辅助组的总有效率(94.29%)高于阿奇霉素组(77.14%),差异有统计学意义(P<0.05);Ig辅助组的脑脊液白细胞水平和血清C反应蛋白(CRP)、降钙素原(PCT)水平均低于阿奇霉素组,差异有统计学意义(P<0.05);Ig辅助组的动脉血氧分压(PO_(2))高于阿奇霉素组,动脉二氧化碳分压(PCO_(2))低于阿奇霉素组,差异有统计学意义(P<0.05);Ig辅助组的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰值流速(PEF)水平均高于阿奇霉素组,差异有统计学意义(P<0.05);Ig辅助组、阿奇霉素组的不良反应发生率分别为20.00%、14.29%,两组间比较差异无统计学意义(P>0.05)。结论:人Ig辅助阿奇霉素治疗MPP合并CNSD,能有效控制脑脊液和机体全身的炎症,调节肺功能促进血气恢复,且不增加不良反应,安全性良好。

Objective: To investigate the effect of human immunoglobulin(Ig) adjuvant treatment in children with Mycoplasma pneumoniae pneumonia(MPP) complicated with central nervous system damage(CNSD) in children. Method: A total of 70 children with MPP complicated with CNSD admitted to Pingnan County People’s Hospital from August 2021 to June 2022 were randomly divided into Azithromycin group and Ig-assisted group, with 35 cases in each group. All children received routine symptomatic support treatment.The Azithromycin group was given oral Azithromycin, and the Ig adjuvant group was given human Ig adjuvant treatment on the basis of the Azithromycin group. The curative effect, cerebrospinal fluid leukocyte level, serum inflammatory factor level, blood gas analysis, lung function and adverse reactions were compared between the two groups. Result: After treatment, the total effective rate of Ig adjuvant group(94.29%) was higher than that of Azithromycin group(77.14%), the difference was statistically significant(P<0.05). The level of cerebrospinal fluid leukocyte, serum C-reactive protein(CRP) and procalcitonin(PCT) in the Ig-assisted group were significantly lower than those in the Azithromycin group, the differences were statistically significant(P<0.05). The arterial partial pressure of oxygen(PO2)in the Ig-assisted group was higher than that in the Azithromycin group, and the arterial partial pressure of carbon dioxide(PCO2) was lower than that in the Azithromycin group, the differences were statistically significant(P<0.05). The levels of the first second forced expiratory volume(FEV_(1)), forced vital capacity(FVC) and peak expiratory flow rate(PEF) of Ig assisted group were higher than those of Azithromycin group, and the differences were statistically significant(P<0.05). The incidence of adverse reactions in the Ig adjuvant group and Azithromycin group was 20.00% and 14.29% respectively, and there was no statistically significant difference between the two groups(P>0.05). Conclusion: Human Ig assisted Azithromycin in the treatment of MPP combined with CNSD can effectively control the inflammation of cerebrospinal fluid and the whole body, regulate lung function and promote the recovery of blood gas, and does not increase adverse reactions, with good safety.