细菌溶解产物联合甲强龙对支气管肺炎患儿的疗效

Effect of bacterial lysates combined with methylprednisolone on children with bronchopneumonia

目的探究细菌溶解产物联合甲强龙对支气管肺炎患儿肺功能、免疫球蛋白(Ig)、炎症因子水平的影响。方法选取2021年4月至2023年4月许昌市人民医院收治的98例支气管肺炎患儿为研究对象,依据双色球法将其随机分为对照组(49例)、观察组(49例)。对照组男25例,女24例,年龄(7.59±1.52)岁;观察组男27例,女22例,年龄(8.01±1.72)岁。对照组给予甲强龙治疗,静脉滴注,1 mg/kg,qd,连续滴注3 d,观察组在此基础上给予细菌溶解产物胶囊治疗,3.5 mg/次,qd,每日空腹口服,连续服用10 d。比较两组临床疗效,临床症状恢复时间,治疗前后用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)、IgA、IgM、IgG、C反应蛋白(CRP)、转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)水平及不良反应发生率。采用t检验、χ2检验。结果治疗后观察组总有效率97.96%(48/49),高于对照组83.67%(41/49),差异有统计学意义(P<0.05)。观察组高热、咳嗽、气促及啰音恢复时间均短于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组PEF、FVC、FEV1水平分别为(3.01±0.48)L/s、(1.56±0.22)L、(1.39±0.28)L,高于对照组的(2.72±0.39)L/s、(1.38±0.19)L、(1.23±0.18)L,差异均有统计学意义(均P<0.05)。治疗后,观察组IgA、IgM、IgG水平分别为(1.35±0.12)g/L、(1.44±0.31)g/L、(10.37±1.68)g/L,高于对照组的(1.08±0.09)g/L、(1.11±0.36)g/L、(8.35±0.79)g/L,差异均有统计学意义(均P<0.05)。治疗后,观察组TGF-β1、CRP、IL-4及TNF-α水平降低幅度大于对照组,差异均有统计学意义(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论细菌溶解产物联合甲强龙治疗支气管肺炎患儿疗效显著,可改善肺功能,抑制炎症因子表达,提高免疫力,安全性良好。

Objective To investigate the effect of bacterial lysates combined with methylprednisolone on the lung function,immunoglobulin(Ig),and inflammatory factors in children with bronchopneumonia.Methods A total of 98 children with bronchopneumonia admitted to Xuchang People's Hospital from April 2021 to April 2023 were selected as the research objects,and were randomly divided into a control group(49 cases)and an observation group(49 cases)according to the two-color sphere method.The control group included 25 boys and 24 girls,aged(7.59±1.52)years.The observation group included 27 boys and 22 girls,aged(8.01±1.72)years.The control group was given methylprednisolone treatment,intravenous infusion,1 mg/kg,qd,continuous infusion for 3 days,and on the basis the observation group was given bacterial lysate capsules,3.5 mg/time,qd,oral fasting daily for 10 days.The clinical efficacy,recovery time of clinical symptoms,forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximum expiratory flow(PEF),IgA,IgM,IgG,C-reactive protein(CRP),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and interleukin-4(IL-4)levels before and after treatment,incidence of adverse reactions were compared between the two groups.t test andχ2 test were used.Results After treatment,the total effective rate of the observation group was 97.96%(48/49),which was higher than that of the control group[83.67%(41/49)],with a statistically significant difference(P<0.05).The recovery time of high fever,cough,shortness of breath,and rales in the observation group were shorter than those in the control group,with statistically significant differences(all P<0.05).After treatment,the PEF,FVC,and FEV1 levels in the observation group were(3.01±0.48)L/s,(1.56±0.22)L,and(1.39±0.28)L,which were higher than those in the control group[(2.72±0.39)L/s,(1.38±0.19)L,and(1.23±0.18)L],with statistically significant differences(all P<0.05).After treatment,the levels of IgA,IgM,and IgG in the observation group were(1.35±0.12)g/L,(1.44±0.31)g/L and(10.37±1.68)g/L,which were higher than those in the control group[(1.08±0.09)g/L,(1.11±0.36)g/L,and(8.35±0.79)g/L],with statistically significant differences(all P<0.05).After treatment,the levels of TGF-β1,CRP,IL-4,and TNF-αin the observation group were decreased more than those in the control group,with statistically significant differences(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Bacterial lysates combined with methylprednisolone is effective in the treatment of children with bronchopneumonia,which can improve the lung function,inhibit the expressions of inflammatory factors,and improve the immunity,with good safety.