更昔洛韦联合丙种球蛋白对腺病毒肺炎患儿免疫球蛋白、T淋巴细胞亚群及炎症因子的影响

Effect of ganciclovir combined with gamma globulin on immunoglobulin,T lymphocyte subsets and inflammatory factors in children with adenovirus pneumonia

目的:观察更昔洛韦联合丙种球蛋白对腺病毒肺炎患儿免疫球蛋白、T淋巴细胞亚群及炎症因子的影响.方法:选取2018年1月—2022年5月我院收治的86例腺病毒肺炎患儿为研究对象,采用随机数字表法分为对照组(n=43)和观察组(n=43).对照组患儿采用更昔洛韦治疗,观察组患儿采用更昔洛韦联合丙种球蛋白治疗,连续治疗2周.比较两组患儿疗效相关指标、不良反应率,检测两组患儿细胞、体液免疫功能及炎症相关因子的变化.结果:观察组患儿退热时间、止咳时间、肺部湿啰音消失时间及住院时间均明显短于对照组,差异具有统计学差异.治疗前,两组患儿细胞、体液免疫功能指标及炎症相关因子比较,无统计学差异;治疗2周后,两组患儿CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平均明显高于治疗前,肿瘤坏死因子α(TNF-α)、白介素-1(IL-1)、白介素-2(IL-2)、克拉拉细胞分泌蛋白(CCSP)、CD8^(+)、免疫球蛋白M(IgM)水平均明显低于治疗前;治疗2周后,观察组患儿CD8^(+)、IgM、炎症相关因子低于对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgG高于对照组;观察组患儿累计不良反应为13.95%与对照组的9.30%比较,无统计学差异.结论:更昔洛韦联合丙种球蛋白可提高腺病毒肺炎患儿细胞和体液免疫功能,抑制炎症的表达,减轻症状,有利于患儿康复.

Objective To observe the effect of ganciclovir combined with gamma globulin on immunoglobulin,T lymphocyte subsets and inflammatory factors in children with adenovirus pneumonia.Methods 86 children with adenovirus pneumonia admitted to our hospital from January 2018 to May 2022 were selected as the research object,and were divided into two groups by random number table.The control group was treated with ganciclovir,and the observation group was treated with ganciclovir combined with gamma globulin for 2 consecutive weeks.The efficacy related indexes and adverse reaction rate of the two groups were compared,and the changes of cellular and humoral immune functions and inflammatory related factors were detected.Results The antipyretic time,cough stopping time,lung moist rale disappearance time nd hospitalization time in the observation group were shorter than those in the control group.Before treatment,there was no significant diference between the two groups in terms of cellular and humoral immune function indexes and inflammatory related factors.After 2 weeks of treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin A(IgA)and immunoglobulin G(IgG)in both groups were higher than those before treatment,and tumor necrosis factorα(TNF-α)、Interleukin-1(IL-1),interleukin-2(IL-2),Clara cell secretory protein(CCSP),CD8^(+),and immunoglobulin M(IgM)were lower than those before treatment.After 2 weeks of treatment,CD8^(+),IgM,and inflammatory related factors in the observation group were lower than those in the control group,while CD3^(+),CD4^(+),CD4^(+)/CD8^(+),IgA,and IgG were higher than those in the control group.The cumulative adverse reactions in the observation group were 13.95%and 9.30%in the control group,with no statistical difference.Conclusion Ganciclovir combined with gamma globulin can improve the cellular and humoral immune function of children with adenovirus pneumonia,inhibit the expression of inflammation,reduce symptoms,and help children recover.