人免疫球蛋白联合美罗培南对老年重症肺部感染患者的疗效

Therapeutic effect of human immunoglobulin combined with meropenem in elderly patients with severe pulmonary infection

目的探究人免疫球蛋白联合美罗培南治疗老年重症肺部感染(severe pulmonary infection,SPI)患者的疗效及对T淋巴细胞亚群的影响。方法将189例老年SPI患者用随机数字表法分为对照组(n=94)和观察组(n=95)。在常规治疗的基础上,对照组予以美罗培南静脉注射治疗,观察组在对照组治疗的基础上予以人免疫球蛋白(pH4)静脉注射治疗,比较2组的疗效、临床指标以及治疗前后外周血T淋巴细胞比例、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白C(immunoglobulin C,IgC)、免疫球蛋白M(immunoglobulin M,IgM)以及血清炎症因子水平。结果观察组的总有效率(92.63%)高于对照组(82.98%),P<0.05;治疗后,观察组的病原菌转阴率高于对照组(P<0.05),咳嗽咳痰消退时间、发热消退时间及胸部X线片恢复正常时间、住院时间和呼吸机使用时间均短于对照组(P<0.05);2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgC和IgM均高于治疗前,且观察组高于对照组(P<0.05);2组CD8^(+)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)均低于治疗前(P<0.05);且观察组均低于对照组(P<0.05)。2组不良反应发生率及死亡率比较差异无统计学意义(P>0.05)。结论人免疫球蛋白联合美罗培南治疗老年SPI患者,疗效确切,可提高机体免疫能力,降低炎症反应。

Objective To investigate the efficacy of human immunoglobulin combined with meropenem in the treatment of elderly patients with severe pulmonary infection(SPI),and the influence on T lymphocyte subsets.Methods A total of 189 elderly patients with SPI were enrolled and divided into a control group(n=94)and an observation group(n=95)by random number table method.The patients in the control group received Intravenous Injections of Meropenem on the basis of conventional treatment,and those in the observation group received Intravenous Injections of Human Immunoglobulin(pH4)on the basis of the treatment of the control group.The curative effect,clinical indicators,the proportions of peripheral blood T lymphocyte subsets,the levels of IgA,IgC and IgM,and serum inflammatory factor were compared between the 2 groups.Results The total treatment response rate in the observation group(92.63%)was higher than that in the control group(82.98%)(P<0.05).After treatment,the negative conversion rate of pathogenic bacteria in the observation group was higher than that in the control group(P<0.05).The regression time of cough and expectoration,the regression time of fever,the recovery time of chest X-ray film,the time of hospital stay and the time of ventilator use in the observation group were shorter than those in the control group(P<0.05).After treatment,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin A(IgA),immunoglobulin C(IgC)and immunoglobulin M(IgM)increased.These indicators in the observation group were higher than those in the control group(P<0.05).The CD8^(+),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)decreased,and the levels in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions or mortality between the 2 groups(P>0.05).Conclusion Human immunoglobulin combined with meropenem is effective in treating elderly patients with SPI.It can improve immunity and reduce inflammatory response in the patients.