人免疫球蛋白联合甲泼尼龙治疗儿童重症肺炎的疗效评价

Efficacy Evaluation of Human Immunoglobulin Combinded with Methylprednisolone in the Treatment of Severe Pneumonia in Children

目的:探讨人免疫球蛋白在需甲泼尼龙(注射用甲泼尼龙琥珀酸钠)治疗的儿童重症肺炎的应用价值。方法:回顾性分析2021年1月至2022年6月在我院住院的重症肺炎患儿资料,选取其中使用了甲泼尼龙但未使用人免疫球蛋白辅助治疗的44例患儿为对照组,同时使用了甲泼尼龙和人免疫球蛋白辅助治疗的47例患儿为观察组,比较两组患儿的临床症状改善时间、治疗前后影像学、检验结果、疗效及不良反应发生情况。结果:观察组总有效率为91.49%,高于对照组的70.45%;临床症状改善时间短于对照组;治疗2周后肺部阴影吸收≥80%的患儿比例高于对照组;C反应蛋白(CRP)、白细胞(WBC)计数、降钙素原(PCT)等检验指标降低幅度大于对照组(P均<0.05)。两组患儿均无药物不良反应发生。结论:在甲泼尼龙辅助治疗的儿童重症肺炎同时应用人免疫球蛋白安全可行,可有效提高临床疗效。但考虑静脉用人免疫球蛋白属于血液制品,价格昂贵并存在用药风险,建议用药前与患者家属充分沟通,严格遵照用药指征选用。

Objective:To probe into the application value of human immunoglobulin in the treatment of severe pneumonia in children requiring methylprednisolone(methylprednisolone sodium succinate for injection).Methods:Clinical data of children with severe pneumonia hospitalized in our hospital from Jan.2021 to Jun.2022 were retrospectively analyzed.Forty-four children who received methylprednisolone but no human immunoglobulin as adjuvant therapy were selected as the control group,and 47 children who received methylprednisolone and human immunoglobulin as adjuvant therapy were selected as the observation group.The improvement time of clinical symptom,imaging before and after treatment,test results,efficacy and adverse drug reactions of two groups were analyzed.Results:The total effective rate of the observation group(91.49%)was higher than that of the control group(70.45%).The improvement time of clinical symptoms in the observation group was shorter than that of the control group.The proportion of children with lung shadow absorption≥80%was higher than that of control group after 2 weeks of treatment.The reduction of C-reactive protein(CRP),white blood cell(WBC)count and procalcitonin(PCT)in the observation group was greater than that in control group(P<0.05).No adverse drug reactions occurred in two groups.Conclusion:The application of human immunoglobulin in children with severe pneumonia with methylprednisolone as adjuvant treatment is safe and feasible,which can effectively improve the clinical efficacy.Considering that intravenous human immunoglobulin is the blood product with high cost and medication risk,it is recommended that the clinicians should use human immunoglobulin strictly according to the indications after full communication with family members of patients.