静脉注射人免疫球蛋白联合抗生素治疗小儿重症肺炎的效果分析

Therapeutic effect of intravenous human immunoglobulin combined with antibiotics in treatment of severe pneumonia in children

目的分析静脉注射人免疫球蛋白联合抗生素治疗小儿重症肺炎的临床效果。方法队列研究。抽取2019年12月至2022年12月河南科技大学第一附属医院收治的小儿重症肺炎患儿86例,以随机数字表法分为研究组和常规组,每组43例。常规组予以抗生素治疗,研究组在常规组基础上联合静脉注射人免疫球蛋白治疗。对比两组效果、症状消退时间(退热时间、咳嗽消退时间、平喘时间、啰音消退时间、住院时间)、肺功能[用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)、呼吸峰流速(PEF)、最大呼气压(MEP)、最大吸气压(MIP)]水平、免疫功能[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)]水平、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]水平及不良反应发生率。结果研究组治疗总有效率(95.35%,41/43)高于常规组(76.64%,33/43),P<0.05。研究组退热时间、咳嗽消退时间、平喘时间、啰音消退时间、住院时间短于常规组(P<0.05);治疗后,研究组FVC、FEV1、PEF、MEP、MIP水平高于常规组(P<0.05)。治疗后,研究组IgG、IgM水平高于常规组(P<0.05),两组IgA水平比较差异未见统计学意义(P>0.05)。治疗后,研究组CRP、TNF-α、IFN-γ水平低于常规组(P<0.05)。研究组不良反应发生率(9.30%,4/43)低于常规组(25.58%,11/43),P<0.05。结论静脉注射人免疫球蛋白联合抗生素治疗小儿重症肺炎患儿效果确切,可改善免疫功能和炎症反应,缩短临床症状改善时间,提高肺功能,并可减少不良反应。

Objective To analyze the clinical effect of intravenous human immunoglobulin combined with antibiotics in the treatment of severe pneumonia in children.Methods A total of 86 children with severe pneumonia treated in the First Affiliated Hospital of Henan University of Science and Technology from December 2019 to December 2022 were selected for the cohort study.And the selected patients were divided into the study group and the conventional group by random number table method,with 43 cases in each group.The conventional group was treated with antibiotics,and the study group was treated with intravenous human immunoglobulin on the basis of conventional treatment.The efficacy,symptom resolution time(fever resolution time,cough resolution time,asthma resolution time,rale resolution time,hospital stay time),pulmonary function assessed by forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak respiratory velocity(PEF),maximal expiratory pressure(MEP),and maximal inspiratory pressure(MIP),immune function assessed by levels of immunoglobulin G(IgG),immunoglobulin A(IgA)and immunoglobulin M(IgM),levels of inflammatory factors,including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the study group(95.35%,41/43)was higher than that of the conventional group(76.64%,33/43),P<0.05.The duration of fever resolution,cough resolution,asthma resolution,rales resolution and hospital stay in the study group were shorter than those in the conventional group(P<0.05).After treatment,the levels of FVC,FEV1,PEF,MEP and MIP in the study group were higher than those in the conventional group(P<0.05).After treatment,the IgG and IgM levels of the study group were higher than those of the conventional group(P<0.05),but there was no significant differences in level of IgA between the two groups(P>0.05).After treatment,the levels of CRP,TNF-αand IFN-γin the study group were lower than those in the conventional group(P<0.05).The incidence of adverse reactions in the study group(9.30%,4/43)was lower than that in the conventional group(25.58%,11/43),P<0.05.Conclusions Intravenous human immunoglobulin combined with antibiotics in the treatment of children with severe pneumonia can improve immune function and inflammatory response,shorten the time of clinical symptoms improvement,improve lung function,and reduce adverse reactions.