利奈唑胺联合支气管肺泡灌洗治疗小儿重症肺炎的效果观察

Therapeutic effect of linezolid combined with bronchoalveolar lavage on severe pneumonia in children

目的探讨利奈唑胺联合支气管肺泡灌洗治疗小儿重症肺炎的效果。方法抽取2021年7月至2022年7月漯河市第二人民医院收治的重症肺炎患儿72例,按照随机数字表法分为对照组与研究组,每组36例。对照组给予支气管肺泡灌洗治疗,研究组给予利奈唑胺联合支气管肺泡灌洗治疗。比较两组临床症状改善情况及治疗效果。比较两组治疗前后肺通气指标(氧合指数、动脉血氧分压、血氧饱和度)、辅助性T细胞1/辅助性T细胞2(Th1/Th2)趋化因子(γ干扰素、白细胞介素-4)水平及炎性细胞因子(C反应蛋白、降钙素原)水平。结果治疗后,研究组退热时间、咳嗽消失时间、肺啰音消失时间、住院时间均短于对照组(P均<0.05)。治疗后3 d,研究组氧合指数、动脉血氧分压、血氧饱和度水平高于对照组(P<0.05)。治疗后3 d,研究组γ干扰素、γ干扰素/白细胞介素-4水平高于对照组,白细胞介素-4、C反应蛋白、降钙素原水平低于对照组(P<0.05)。研究组治疗有效率(91.67%,33/36)高于对照组(72.22%,26/36),差异有统计学意义(χ^(2)=0.03,P<0.05)。结论利奈唑胺联合支气管肺泡灌洗治疗小儿重症肺炎疗效确切,可有效改善患儿肺通气功能、炎症反应,其机制或与调节Th1/Th2趋化因子水平、病情控制良好有关。

Objective To investigate the therapeutic effect of linezolid combined with bronchoalveolar lavage on severe pneumonia in children.Methods A total of 72 children with severe pneumonia admitted to Luohe Second People’s Hospital from July 2021 to July 2022 were selected and divided into control group and study group by random number table method,with 36 cases in each group.The control group was treated by bronchoalveolar lavage,and the study group was treated by linezolid combined with bronchoalveolar lavage.The improvement of clinical symptoms and clinical efficacy of the two groups were compared.The ventilation indexes(oxygenation index,arterial partial pressure of oxygen,and saturation of blood oxygen),levels of T helper cell 1/T helper cell 2(Th1/Th2)chemokines(interferon,interleukin-4),and levels of inflammatory cytokines(C-reactive protein and procalcitonin)of the two groups were compared before and after treatment.Results After treatment,the disappearing time of symptoms(fever,cough and rales)and hospital stay in the study group were shorter than those in the control group(all P<0.05).Three days after treatment,the oxygenation index,arterial partial pressure of oxygen and saturation of blood oxygen in the study group were higher than those in the control group(P<0.05).The level of interferon-γand interferon-γ/interleukin-4 in the study group were higher than those in the control group,while the levels of interleukin-4,C-reactive protein and procalcitonin in the study group were lower than those in the control group 3 days after treatment(P<0.05).The clinical effective rate of the study group(91.67%,33/36)was higher than that of the control group(72.22%,26/36),and the difference was significant(χ^(2)=0.03,P<0.05).Conclusions Linezolid combined with bronchoalveolar lavage has definite curative effect on severe pneumonia in children,which can effectively improve lung ventilation function and inflammatory response in children,and its mechanism may be related to the regulation of Th1/Th2 chemokines and good disease control.