重症肺炎并发心力衰竭患儿应用丙种球蛋白治疗对其血清IGF-1、cTnI水平的影响观察

Effect of Gamma Globulin Treatment on Serum IGF-1 and cTnI Levels in Children with Severe Pneumonia Complicated with Heart Failure

目的 观察应用丙种球蛋白对重症肺炎并发心力衰竭患儿的血清胰岛素样生长因子-1(IGF-1)、肌钙蛋白Ⅰ(cTnⅠ)水平影响。方法 选取我院收治的65例重症肺炎并发心力衰竭患儿,随机分为常规治疗的对照组(n=34)和常规治疗+丙种球蛋白治疗的研究组(n=31),比较两组患儿的疗效及治疗前后的炎症水平[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]、心功能指标[肌钙蛋白Ⅰ(cTnⅠ)、B型脑利钠肽(BNP)、胰岛素样生长因子-1(IGF-1)]、免疫球蛋白水平(IgG、IgM、Ig A)、预后(阳性症状缓解时间、住院时间)。结果 治疗后,研究组治疗有效率、IGF-1、IgG、IgM、IgA水平显著高于对照组(P<0.05),cTnⅠ、BNP、CRP、TNF-α、IL-6水平显著低于对照组(P<0.05),阳性症状缓解时间、住院时间均显著短于对照组(P<0.05)。结论 丙种球蛋白治疗重症肺炎并发心力衰竭疗效显著,可减轻患儿炎症状态、改善心功能、提高免疫力、促进转归。

Objective To observe the effect of gamma globulin on serum levels of insulin-like growth factor-1(IGF-1)and troponinⅠ(cTnⅠ)in children with severe pneumonia complicated with heart failure.Methods A total of 65 children with severe pneumonia complicated with heart failure were recruited and randomly divided into conventional treatment control group(n=34)and conventional treatment plus gamma globulin treatment study group(n=31).The curative effect,inflammatory levels[C-reactive protein(CRP),tumor necrosis factorα(TNF-α),interleukin 6(IL-6)],cardiac function indexes[troponin I(CTN I),B-type brain natriuretic peptide(BNP),insulin-like growth factor-1(IGF-1)]and immunoglobulin levels before and after treatment were compared between the two groups.Results After treatment,the treatment response rate,IGF-1,IgG,IgM and IgA levels in the study group were significantly higher than those in the control group(P<0.05),the levels of cTnⅠ,BNP,CRP,TNF-αand IL-6 were significantly lower than those in the control group(P<0.05),and the remission time of positive symptoms and hospital stay were significantly shorter than those in the control group(P<0.05).Conclusion Gamma globulin is effective in the treatment of severe pneumonia complicated with heart failure,which can reduce the inflammatory state of children,improve their heart function,enhance their immunity and promote the outcome.